ThinnerTimes - Gastric Bypass and Lap Band® Forum - View Single Post

Squishy · 02-02-2007, 10:25 PM

I apologize, because this is going to be long, but I hope it helps.

First, the company for which you work undoubtedly has an insurance representative in the Human Resources department. Go and explain your situation to that person and ask if there is anything he or she can do to help. Usually, you have to submit the bill and then they release the payment. It is unusual for you to have to pay it first. You may have been mis-informed and the insurance person could clear it up for you. If that is the rule, maybe they could get it waved under the circumstances. Maybe your employer would give you a payroll advance with a simple written agreement that you would pay it back as soon as your reimbursement arrived. They may be willing to do this since they can take it out of your pay if you don't pay. Their risk is pretty low.

If that doesn't work, try this...

If you meet with the clinic accountant/payment person and showed them the balance in your flex spending account, and explain the reimbursement process, would they allow you to make small payments you can afford. You could make the first payment out of your pocket, submit it and then use the reimbursement money to make the next payment, submit it for reimbursement, etc. until it is paid off? I bet they would.

Explain that you were responsible and planned ahead by depositing money in your flexible spending account, but that you have learned that you can only receive the money as reimbursement for payments and that you just cannot afford to pay it all at once, even though you have the full amount in your flex spending account. (Show them the statement)

Explain that you have gone through all of the preparation and pre-testing for the surgery for the past X months and that if you cannot work out a payment plan, that you will have to cancel the surgery and begin the process again. Further explain that if you have to start over, you will have wasted the money you save to pay for the process.

Most hospitals and clinics make payment arrangements with people all the time, so if you demonstrate that you have the money, I'm guessing that they would work it out with you.

If the first person you talk to says "no", don't argue with him or her. You want him or her to help you and challenging them or making them angry won't help you get what you want. Say "I understand that you have to work within the guidelines that you are given, but I'm sure you can empathisize with my situation." Then very politely ask if there is a department head or someone to whom you could talk to see if he or she might have the ability to make a special arrangement.

If they get a manager, explain that the first person you talked to has been very nice and was trying to help, but could not make an arrangement with you.

Tell the manager what you explained to the first person, explain that you know that this is not their normal process, and ask if there is any way that he or she could help you. If they cannot do a payment plan, ask if they had a speaker phone and if they would get on a call with you to Blue Cross to see if there is any documentation that the clinic could provide that would enable them to release the payment. It could even be sent directly to the clinic if they are worried that you would not bring it in.

C'mon...you can do this! Start with your employer's insurance manager on Monday! Let me know what you find out.

-Mike-