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El Paso, TX, United States
Still Wondering What's Next? Anything at Anytime (I) has/have had a rough start to the year. Sorry for the delays in Posts and I Promise to do better. No Excuses as Life Must GO ON! So Keep an Eye Open... Oh, if you would like to follow on Twitter I am @DanWins2007.

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Tuesday, July 13, 2010

Understanding.......... INSURANCE?!?

Today was call my oxygen provider company to make payment arrangements day.

Our bill was getting weird and my wife and I couldn't figure it out. So I told her I would call them and see what was going on with the bill and to make arrangements to pay and make Everyone (but our pockets) happy.

The Lady I talked to was a little bit older and was very helpful trying to explain it to me. She and I both got mildly frustrated with the situation - not with each other but the situation and trying to figure out the math.

Now, I am pretty good at math. Not a math wiz or anything like that but having a few hours under my belt for a physics with a minor in mathematics degree, I think I can follow most math.

Who the Hell thought up all these damn formulas for insurance and how much who owes what and what owes who and why that cost this and not that and you can only have one of those otherwise the cost will be 7 times the cost divided by the 31st figure in the 14th dynasty's 3rd reign.........

and if that one doesn't explain it -

Well, sir I truly don't know why the insurance says you owe that much more, remember I work for the oxygen company (which is true and I told her so).  She then goes on to say something like : You think that is bad,  this is the rules as the insurance sets them down before us and we are the ones they are supposed to pay:  You being the Recievee and We  the payer and your patient/our customer the object in question will all interact thusly,  The Recievee will provide services to the patient/our customer and bill them 10 times the going rate at which point we the insurance shall tell you the Recievee that you are over billing us the Payer by 7 times the amount that it should be then we will tell the patient/our customer to pay you 4 times the actual worth of the product for the next 6 months.  Then and only then will we the Payer pay the Recievee whatever the patient/our customer hasn't which will be the total of 80 % of the total after subtracting their 20 % minus the additional fees that were added minus the sum total of over payments by cents Plus the sub-total minus the fraction of the overcharge and by the time it is done We the Payer Will Pay you the Recievee $0.01 while your patient/our customer pays you $2800.00 and our customer will continue to pay us the family coverage total of roughly $500.00 per month with an individual deductible of $1500.00 and $3000.00 for the family. 


So rather than make matters totally Discombobulated with the Nice Old Lady, I said: "Ma'am, thank you for trying to explain it to me but I don't think we have figured it out yet.  I will talk to the wife and we will pay you $---.-- and that should put us all right for now until I can get this straightened out with Insurance."

Her response: "Mr. Wins2007, Thank You that will be fine for now.  And Sir?"  "Yes?" I said.

"Good Luck!"


  1. You hit the nail on the head with this one. That was how the presentation was when they increased our monthly rates and our deductible. When we left we had more questions than answers. The best part is that I get the great job of calling the insurance to see what is going on. I will need a large cup of coffee and a huge bottle of advil for that call.

  2. Okay, Insurance Companies drive me crazy! I have always said and will continue to say, "When it comes to the insurance company and they need to pay up it is a never ending story and long lines of BS. It takes forever to get a claim payed on their part." But!!! However if you don't pay your monthly bill to them it takes them no time to drop you and your insurance. WTF??? It's a bureaucratic line of crap. and Jacqueline I agree with you once all is said and restated a hundred million times Advil will be your best friend when you are done talking a blue streak to these people.

    All the best to both of you.


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