Friday, September 26, 2008

With a little faith...

... big things happen!

When I was younger and I had a question, like "how do you spell...?" or "what does... mean?", Mom would lovingly tell me "Look it up!" This has always seemed to me a good philosophy to follow. If you don't know something, or need more information, look it up! Do your research! Ask whatever questions you need to. That way you always have enough info to get the job done.

I know this is the third day I have posted about this, but it's such a huge event for us right now. I could easily have gotten completely overwhelmed and majorly stressed about all the work involved, the little details, the big financial details. But because I am on the medication that I am, I have been able to learn how to take a deep breath and trust that things will work out. Everytime I do, it does! It may not work out how I think it will, but in the end, things end up flowing together in such a way that it works.

I did it the same way this time. I just took a big, deep breath. I called Tricare, and asked 50 billion questions of 2 different departments, until I was sure that I knew what was going on, how all the red tape would work, how the money would work. Who would have to put in what referrals... All that. And it is a good thing that I knew exactly what was going on.

Because today, I got a hold of the insurance and billing department of Dr. Beck's office. She had no idea what I was talking about and kept repeating the same stuff over and over, didn't listen to the question I had, assumed I was an idiot who didn't understand what she was saying.... So she gave me the name of the lady back there who deals with all the Tricare cases. Thank you! I left a message for her and she called me back within 2 hours. She knew what she was talking about, she treated me like an intelligent human being, she answered my questions clearly and consisely, until I knew how they billed what and why. Turns out that the 15% we pay is 15% of what Tricare pays. They pay $100 out of $145, we pay 15% of the $100. So the $70 was the money that Tricare would have paid plus what we were supposed to pay. We still overpayed, but we will get reimbursed for the full amount.

Then, we discussed how to go about seeing Dr. Lassaso, for the videoflouroscopy Dr. Beck wants. I let her know what Tricare's red tape is about that, since we weren't sure if she was a Tricare provider. I also had the names of all the Speech Pathologists withing 100 miles that were, so she could check if any of them could do it. And their numbers. :-) See, I did my checking, Mom. I looked it up! :-)

I had called our pediactric nurse yesterday and left a message about the Lassaso thing, and he called back this afternoon. He was kind enough to pull up their database, and it turns out that she is indeed a Tricare provider, and a referral won't be a problem! She works in the St. Lukes hospital and everything, we won't have to worry about paying her anything. Dr. Beck just has to put in the referral request for Dr. Lassaso, and get approval. That will take a couple of days. We already have an appointment set up for Oct. 7th with her, we just need that authorization number and we should have plenty of time!

All this because I had faith that if I just did all that I could, did all the work that I could do, and was fully informed, the Lord would take care of the rest. People have called back quickly, and have been very willing to help me. My questions have all been answered, and all my concerns have been taken care of. I know most of what to expect. And even the financial has worked itself out! I can arrange with Dr. Beck's office to hold off payment until I get the check from Tricare, and then send them the money.

We will just have a percentage of her fee for the surgery, a deposit, to pay. Still a hefty chunk of change, between 40-60%, but that should be a percent of what Tricare would pay. That, we will get reimbursed for. I can do that!

Thank you for all your love and thoughts and prayers! I have really felt more peaceful about all of this, and I know that we are being taken care of and blessed.

4 comments:

Calista said...

Amazing how the Lord gives you just what you need! I can't begin to understand how all of our insurance stuff works, but I haven't NEEDED to understand it to the degree that you do. It's so good that things will all work out for you guys on this so that you can get what you need for your little guy!

Kathy & Dave Whittle said...

The insurance you have is truly a big blessing in your life right now. So glad that things are working out for you and that you are able to feel a little peace about everything.

Karen said...

Diito to both of the above comments. So glad you're able to obtain the info and be at peace.

Rachel H. said...

That is FAB! I am so glad that is working out WAY better than you thought. You give me HOPE!!