Wednesday, January 19, 2011

Twins: Another Reason for Insurers to Mess up Your Claims

When reading Twins! Pregnancy, Birth and the First Year of Life, I was surprised at the following exchange (in one of the "parent discussion" sections):
JOAN: Our insurance company stopped paying on one of the babies because they kept asking, "Why are you sending one baby to the doctor twice in one day?"
LAURA: Our insurance company kept complaining that we were submitting duplicate charges.
NICK: It is mass confusion since the boys were born five months ago. It is amazing that insurance companies don't comprehend twins.
At the time, I found it hard to believe -- twins are not exactly a rare phenomenon.  How could insurance companies be taken aback?

Fortunately, we have not had any denied claims yet; in fact, the insurance company just forked over a large chunk of cash to pay for the boys' NICU stays.  For that I am grateful.  However...

If I go to my insurer's web site and search pharmacy claims for either boy, I get results for both of them.  Clearly, they have programmed their search function to key solely on date of birth.  Of course that doesn't happen for medical claims...

For that, I only get extra results when I search for myself or the boy I share a name with.  For medical claims, the genius programmers set things up to search by name and ignore date of birth (even though both are displayed as the result of the search).

So, yeah, now I can believe an insurance company wouldn't comprehend twins.