Victory

This blog post is about 2 years overdue, but, just like I say about remembering to bathe my kids, better late than never.

Back in 2016, a few months after Lucy was born I wrote a blog post. It was called The Global OB Fee Trap: How to Find and Fight It. It was a very long-winded rant about how my insurance company at the time incorrectly (err, illegally) processed my prenatal care claims and how I bitched at them for long enough that they eventually paid them.

I wrote the post because I was broke and angry and on maternity leave, which is when I typically sleep little enough that I have time to do things like write blog posts. I assumed nobody would read it because everyone knows our healthcare system is fucked and nobody wants to listen to one more hormonal mother rant about it.

Wrong.

Apparently I am not the only broke and angry mama bear out there. Within a few months the post started ranking in Google search for any and all terms related to Global OB or maternity billing. And apparently people search for those terms kind of a lot.

The comments and messages started pouring in from moms, dads and parents to be – telling me they were facing the same issues and asking for advice on how to fight their insurance companies. I was overwhelmed and out of my league because I am not a lawyer, I am not a doctor, and I don’t play either of those things on TV (but hey – hire me!).

Add to that the incredible complexity of each individual insurance plan and company, each state, and each state agency’s differing interpretation of the absurdly vague and constantly changing Affordable Care Act requirements. I felt helpless.

So I did what I always do when I feel lost and confused. I Googled it.

Seriously I Googled the shit out of the ACA, Harvard Pilgrim, benefits administration, healthcare laws, preventative care guidelines. Pretty sure I now know more about the ACA and healthcare administration than any of our elected officials and DEFINITELY more than the leader of the free world. *Facepalm*

And you know what happened? I got fucking pissed. Because I realized how many woman were getting blatantly screwed by their insurance companies during a time in their lives (postpartum) when they especially don’t want to be screwed by ANYONE – including their significant other. Take the hint, guys.

So I did what any over-parented only child would do and I called my dad. I raged for like 20 minutes until he was like, WTF are you calling me for – call someone that makes the rules. Which is when I got that really sad feeling that you get every time you’re like “Moooooooom what’s for dinner?” And then you realize you are the mom. Adulting really is the worst.

But eventually I got over my sad, entitled and pathetic Millennial self and called my State Senator, Cathy Breen. She ignored me, but I don’t blame her because she probably gets like 100 emails a day from people whining about how much their insurance costs.

So I emailed her like 450 more times until one of her staffers was finally like, please Cathy, go meet with this girl so she will stop harassing us. This is how I have achieved most things in life, so, sorry to every customer service or support person I have ever interacted with!

I met with Cathy at a local cafe for coffee, and she was very nice and I think a little surprised at the depth of research that I presented to her regarding the Global OB billing scam that insurance companies are pulling on postpartum moms. Similar to me, her first reaction was “we can’t be the first people to discover this – there must already be some kind of legislation in progress.” I assured her that if there was, it was not on Google, and accepted her offer to “look into it” and “get back to me.”

Now, I speak public servant pretty fluently and I know that that is code for, please forget about it. But to Cathy’s credit (who was just recently re-elected – yay!) she DID look into it and she DID get back to me. In fact, she contacted the state Attorney General and basically wrote a letter to Harvard Pilgrim asking if they were aware of the issue and pressuring them to cut that shit out.

All this took place over the course of like 5000 years (ok fine, like 6 months) but eventually Cathy and I received a letter from the Associate General Counsel of Harvard Pilgrim acknowledging their error, and informing us that it had been corrected. Here are a few of the more exciting excerpts from the letter:

When I received that letter I felt more victorious than when I originally convinced them to pay my Global OB bill. I did a little dance and of course called my dad who assured me that I was in fact, the greatest.

But despite my little victory dance I continued to receive emails every week from other parents in other states (and with other insurance companies) who were up against the same issues and feeling helpless. I have come to terms with the fact that I probably won’t be able to fight this on a national scale right now (although there are days where I get really fired up) but I do try to respond to each and every email, offering support, resources, whatever knowledge or advice I feel is relevant – and encouragement to fight the good fight, even if it feels unlikely to result in a win. Because it is going to take a village to fight this battle. A whole tribe of angry mamas (and dads!) putting the pressure on HARD.

And then last week I got this message from a new mom I had been chatting with months earlier on Instagram – and it felt like the biggest victory of all.

I literally did a happy dance right there at my bathroom sink. You guys – WE. CAN. DO THIS. We are doing this.

You know Millennials get blamed for basically everything that goes south these days – from napkins to fast food – even marriage. But here’s something else you can happily add to our hit list: bullshit insurance policies.

We are “just a bunch of Millennial moms” who are slowly, collaboratively and skillfully changing the healthcare landscape and beyond.

Watch. Out. Patriarchy.

These mamas are coming for you.

 

 

 

 

 

9 thoughts on “Victory

  1. I want to fight my OB office. I was just told after 3 visits they want to put me on a payment plan that I can’t afford. I informed them I have other bills going toward my deductible each month and my deductible will be met soon. This is only for office visits, but I will confirm. Office visits are not expensive and are paid 100% after deductible is met. This is really stressing me out and I’m sure it stresses out a lot of pregnant moms. I didn’t have to do this with my first one.

    1. Hi Rachel, sorry to hear about your situation. Unfortunately there’s not much you can do if your OB is operating outside of a public hospital (in which case you would likely be able to work out a plan with the billing department based on your income). Even though I know it’s frustrating, your OB isn’t really the one to blame here – most have taken to billing patients ahead of time for prenatal care since it gets billed to insurance in a lump sum at the end (global OB billing), and insurance companies are so adept at getting out of paying it that OBs are trying to protect themselves (and their patients) from getting a large lump sum bill after the baby is born. Legally they can bill you however you want and the only way around it is either working with them on a payment plan that works for you – or finding a new doctor. It sucks, I know! That said – your insurance SHOULD cover the cost of all those prenatal visits in the end once the global OB fee is billed (you will be responsible for the diagnostic portion of the care – i.e. delivery, hospital charges, ultrasounds and any other diagnostic tests). If you don’t see your insurance company covering at least 40% of the global OB bill (the preventative care portion) definitely fight them on that!

  2. Hannah,

    My State Representative here in Florida is willing to take on Cigna, one of the largest insurance companies, but the thing they said would be the most helpful for them to see is the entire letter and the responses you received to your State Representative’s letter. Do you have a copy of it you could upload somewhere or could email me directly? My wife and I are suffering through this “Global Fee” scam right now and the insurance company refuses to budge; instead we are supposed to pay a $1700 bill while both of us are unpaid for the next 3 months.

    1. Hi Stuart, so sorry to hear you are going through the same thing -it’s the last thing you want to have to focus on with a new baby in the house! If you can send me your email I would be happy to send you the documentation that I have from Harvard Pilgrim. Thanks for taking on the fight!

  3. Hi Hannah,

    Dealing with the same issues that you mentioned with the Global Fee with my insurance company plan and OB/midwife office here in Georgia.

    Trying to understand the exact steps I should take to at least fight that the insurance company should pay for at least the preventative portion of the Global Fee, but I’m unsure what to do and how to determine that. Any advice here?

    Would love to reach out to you if you’ve provided the same information to other readers. Is there a way to contact you privately? Thanks so much for speaking out and helping other parents!

    1. Hi Amy, sorry you’re going through a similar fight with your insurance company :/ It’s so stressful. Have you read through the other two posts (https://ohbabyrichards.com/2016/07/19/the-global-ob-fee-trap-how-to-find-and-fight-it/ and https://ohbabyrichards.com/2016/07/19/how-to-fight-your-global-ob-fee-bill/)I have on the subject? There are some good tips in there for fighting your insurance company, as well as some additional documents, etc. in the comments on those posts as well. If you have contacted your insurance company already and they are refusing to pay, filing a claim with your state insurance commission is probably the best next step. Take a look through those posts and the comments and let me know if you have additional questions, I’m happy to help. The best way to reach me is direct message on Instagram (@ohbabyrichards) 🙂

  4. I am currently pregnant, living in Ohio, but high risk due to age and other medical issues. I have 100% maternity coverage, no copay, no deductible (through a plan through the post office). My high risk provider doesn’t do global maternity billing. My insurance company said I can send all the claims back after the baby is born to be reprocess as global maternity. However, every claim that was processed shows a copay of $20 and they are piling up quickly due to my frequent visits. Any suggestions on how to fight this? Right now I am collecting all of my eobs in a folder.

    1. Hi Jennifer, if you have 100% maternity coverage with no copay or deductible, you should not be charged a copay for your office visits. I would verify with your insurance company that you do not in fact have any copay, and then relay that information to your doctor and refuse to continue paying the copay. If they argue, arrange to have a 3-way call with your insurance company and your doctor’s billing office so that they can communicate directly with you on the phone. Ask for everything in writing. This sounds like a misunderstanding of your benefits/coverage more than a global billing issue so hopefully you can get it worked out quickly!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s