More of the same

Since I was on with Humana most of yesterday, I spent a good 4 hours with United Healthcare and Rush University Medical Center claims specialists today.  Equal time and all that.  Instead of measuring progress on getting claims processed and paid, I'm considering measuring by the number of contact points I have within each "inner sanctum" departments at the insurance companies, hospitals & medical facilities.  Raj's claims from March 2011 are no closer to being correctly paid; however, today, I got through to both Kiya and Micah within their respective specialists' departments at Rush (through their supervisor), learned both their last names, got their fax number, and Micah's direct email address.  I also learned the name of the super-duper secret department at UHC that has no outside phone lines, but is the only way to work claims there - the Rapid Resolution Team.  My contacts there grew to both Kimberly (in September) and Robert (in October), no last names are allowed, and they have no fax or email that they'll admit to.  Robert made the mistake of asking whether he could help with anything ELSE today, so I even tossed him the Kiya/Micah issues to see if he can work 'em from the UHC side, even though the error lies with Rush Cardiology and Pulmology not honoring their contracts.

Scoring using the new system, I gained 2 in-network providers today for durable medical equipment, including their step-by-step guidance on how these type of claims work (and coverage level) under Medicare Advantage (Humana, which I have for Raj now) vs. straight Medicare.  I have their direct phone lines, and the fax number for Raj's PCP to send his prescription.

Regarding outpatient procedures (completely different from doctors, inpatient, DME or anything else), I learned that process from my new buddy, Roxanne, and the Alexian Sleep Health Center.  So I'll bring Raj there tomorrow night for another sleep study & pick him up early the next morning before the kids get ready for school.  Since his bed is broken, I figure he'll at least get to sleep on a real bed that night!

Raj said the phlebotomist took his blood this morning, ordered by the new PCP, but I don't get any measurable contact-point progress on this, because nobody knows what entity drew/tested the blood, whether they're in-network, who/what they'll charge, whether it's considered inpatient, outpatient, etc.

Our landline caller ID shows more than 50 outbound calls so far today, and 25 inbound, um - make that 26 . . . .