Healthy billing

Some months ago I found myself in a simultaneous manic/depressive mood that switched from grim to joyous every 15 minutes or so. I was deliriously happy that my health insurance monthly payment had been reduced from $840 to zero, though unhappy that I no longer had health insurance by LifeAstute.

For many years I had grudgingly forked over the money, which would have been a reasonable deal had it cost half as much, but with the yearly double-digit payment increases combined with an ever-increasing list of procedures and prescriptions that my insurance refused to pay, I was paying more and getting less every year. When I tried to call to question my plan, I was instantly put on the elevator music express and let off at the 13th floor, which, as you know, does not exist. Neither does my health insurance.

It seems that LifeAstute wanted an endless flow of paperwork that would cost another $600 per month and they wanted it retroactively, back to the time when man first walked upright and hustled 20 miles per day to get a chunk of raw mastodon. As our little company only had two of us in its ranks and we never missed a payment, why should I submit a copy of every document in my possession? I soon found out the reason.

I was sitting in a booth at a restaurant in Medford — you know, the city that discounts its meals by 5 percent — when by chance a group of LifeAstute auditors sat down in the next booth. I normally ignore conversations in restaurants, but when the name of my former health insurance company repeatedly came up, my ear morphed into a light fixture as I listened to their road warrior heroics.

The thrust of the conversation was that they competed to clear their books of the sick and only insure those who had little statistical chance of needing to see a doctor. I really paid attention when they bragged about some of the tricks of their trade, recoiling when they mentioned cutting off very small companies by overloading them with requested paperwork, while programming the billing computer to randomly deny claims.

Another tactic was to simply refuse to cover many items, forcing either your doctor or you to tip-toe into madness trying to keep up with the reasoning for the denials. Impossibly arcane codes are required to attempt a claim, and each insurance company has a different set of rules. In need of some life-saving surgery? After a staggering deductible, some of the costs will be covered. Want anesthesia? Go buy a new framing hammer and keep it handy as you are wheeled into your meeting with surgeons who are already upset that you are covered by LifeAstute, for they know that they will have to heavily discount their charges, unless they are willing to wait many months for any remuneration.

The list of ruses, ploys and gambits continued throughout the lunch, with each outdoing each other by appearing as merciless as the Grim Reaper. When one of the auditors became giddy explaining their policy of declaring a payment received, not when they get the check, but when the letter gets opened, meaning that even if you sent the money in a week early, they can say it is late because they haven't found time between lunches, dinners, banquets, vacations and junkets to open the envelope.

So I was forced out and found a plan that allows me to have a few things in the refrigerator and use one light bulb at a time. I will not mention the name of my new catastrophic coverage company, but who has heard of NineLives out of Catnip, South Dakota, anyway?

What I really need is to be 20 years old again and have little use for such insurance, at which point I will be hounded day and night to sign up for a little taste of heaven. was last seen playing doctor in his side yard with a fashion model who just moved to town. His wife, Annette, was not amused and will most assuredly deny his claim.

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