Suddenly this week, we experienced a derailment! On Monday, December 30, I received a call
from hospice saying there was a problem with billing. They had not been able to submit any billing
for the services. I was told that they
would look into it and find a new hospice provider and it would be a seamless
transition for Mom.
On Tuesday morning, December 31, I received another call
stating that Mom’s insurance provider was indicating that Mom’s coverage ended
that day. Having worked at a health
insurance company for 20+ years, I said that was correct and if you call
tomorrow (January 1) they will also say coverage ends as of December 31 – of 2014. She was trying to discover what hospices were
participating providers for Mom’s plan.
Anticipating that, I had already looked and was able to give her the
name of a hospice that was covered.
Maybe I was being naïve but in all my years of working in
the health insurance field, I have never known a provider of any kind to begin
treatment without checking to ensure they were a participating provider and
would be paid for their services. Evidently
I just found one that doesn’t… You would
think that it would have taken less than three months for them to realize they
were unable to submit a claim?
Just as I was sitting down to eat lunch that day I received
a call from the new hospice provider.
The prior hospice provider’s three month oversight suddenly required an
emergency on my part and the part of the new hospice provider. I was asked to squeeze in a trip to Mom’s to
sign papers prior to my commitment to my grandchildren that afternoon for New
Year’s Eve. Lovely!
The changeover was much more relaxed. The first day with the first provider I felt
like a train was running over me – not because of Mom’s diagnosis but because
of the number of stressed out hospice people all there talking to me at
once. I went home exhausted that day!
This time Mom and I sat with one nurse and I signed the
papers, provided Mom’s medical ID cards, and we talked about the calls I would
receive over the next few days from various people who would be visiting, checking
and helping Mom.
I’ve received those calls and will now need to keep a close
watch to ensure things are going smoothly again. Today the question of Mom’s coverage came up
again with the new provider. They said
the insurance carrier was stating that Mom’s coverage ended on December 31,
2014. I assured them that she was
covered, checked online and called them back.
I asked what ID number they were using.
The ID number was the issue.
Although Mom’s ID number had not changed, they were still calling in to
the automated system with the number given to them by the previous
provider. It was Daddy’s ID number, not
Mom’s. I know if I call the insurance
provider, they have Mom’s coverage tied to Daddy because she is still covered
under his plan until she passes - even though he died in 1988. Her ID
cards, that I have shared with the ALF, the first hospice and now the second,
show her ID number and that is the number that has to be used for the insurance
company’s automated system. Issue
resolved…
