Us 1, Hospital+Insurance 0

Long, but successful day. After many phone calls, messages, and discussions over the past 4 months, we finally have the insurance straighted out. All of Ann Marie's ground work, and my I'm-not-leaving-the-hospital-today-until-this-is-resolved, payed off. Here are the funny bits we experienced.

• We started the approval process in May, like what, 4 months ahead of time.
  
• All summer long we got plenty of "it's underway, we'll get back to you next week".
• Early September the hospital says "oh, we have you down as 'self-pay'".
• Soon after the insurance company confirms an authorization letter was mailed to us.
• Today the insurance company says they didn't mail an authorization letter, but not to worry because "it's approved". They give me the authorization number, and, at my request, read the procedure code and description.
  
• It turns out I'm authorized for the wrong thing! While the authorized procedure includes the expected words "valve replacement", it also includes words that explicitly exclude the exact type of procedure I'm having.
  
• The surgeon's office admits the hospital submitted the wrong procedure code.
• We leave messages for our hospital admissions representative, the one who is the liason to our insurance company.
• After calls go unanswered, and Ann Marie encourages me to be persistent, I learn that our assigned admissions person left the admissions group early this month!
  
• We ponder whether the "we have you down as self pay" ball-drop has anything to do with the departure since, it turns out, that was the person's last day of working there.
• I meet our new representative, and with her excellent help, straighten the whole thing out!

Wow. While it's difficult to imagine how those without the time or energy handle this stuff, it's good knowing that the excellent medical care at our hospital more than makes up for its administrative woes. There's no doubt in our minds that even if the insurance mixup wasn't detected and resolved ahead of time, that our surgeon would have performed the RIGHT procedure, regardless of what the paperwork said.