More WCF Runaround

I really don’t get it.  Ok, I understand, they are an insurance company, and the only way they make money is by not actually paying out on claims, but seriously.  Weeks ago I went to the Orthopedist for a follow-up after I had the MRI.  If you didn’t already read about that saga, you might want to read this post and this post.  At that follow-up the doctor prescribed and gave me a brace for my knee.  It is specially designed to help hold things in the right place.  When I say prescribed, I mean that I literally have a copy of the scrip in my folder of paperwork for this injury.

Well, I got home last night (after over an hour of wasted time at the theatre) and opened the mail to find a bill from the supplier of the brace.  This was an actual bill, not just a statement saying that things had been taken care of.  Since I received the bill I was at first thinking that WCF must have denied that claim.  This seemed a little strange to me as they had not notified me of the fact that that was the case.  Since one of the first things that WCF sent me upon filing my case was a prescription card, it seemed very strange to me that this prescription would be denied.  I mean, in the grand scheme of things, the brace is significantly less expensive than many pharmaceutical prescriptions so why would this be denied.

Then it occurred to me that since I had heard nothing from WCF about this claim being denied that I really have actually no idea if the supplier even contacted WCF to event try to get them to pay.  So, despite the late hour and all the other things that I have been dealing with (like planning a wedding) I sat down to write to both WCF and the medical supplier.

I have come to two conclusions which I outlined in the emails both ending with the fact that I am not going to pay this bill until some of my questions get answered.  I conclude that WCF needs to actually tell me that this claim was denied and must do so for any future claims.  I also conclude that I have no proof that the supplier talked to WCF at all.  Therefore I won’t pay without further information.  As I said before, I don’t see any reason why this would be denied at all.

There is one other thing that I outlined in my email to WCF, and that is that if the claim was actually denied, it an be submitted to my personal insurance.  However, I can’t make that claim to my insurance without proof of denial.  Also, I don’t want to have to deal with anyone else, so I want the WCF people to deal with talking to my insurance.  Since this case is supposed to fall under their purview I shouldn’t have to be the one stuck in the middle.  I don’t have the time or the patience for it.  Besides, it is what these people are paid to do, fight with eachother over money, I have more important things to deal with.

Needless to say, I am sick of bureaucracy standing in the way of my recovery.  I would just like to be able to walk without limping or hobbling and I would like to it to be comfortable to bend my knee.  It is such a great thing that our healthcare system works






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