The Never Ending Paper Trail

Having tucked the kids into bed this evening, I contemplated blogging about almost-special-education, or tucking myself into bed, when I realized that the cake Dianthus, Aster and I baked for Dianthus's end of school year birthday celebration tasted bad and had an odd underbaked hole.  I've always wondered if baking soda and baking powder were really functionally equivalent.  Now I know.  They are not.
So, as I was throwing together a second cake, I remembered that Aster's enrollment packet for the three-year-old program needs to be completed by tomorrow and we just received a bill for blood work done in February that perhaps I should look into.
The cake is baked, the packet is done and I'm avoiding the hospital bill for another day.

For being a laid-back kid, Aster requires a great deal of paperwork.

So far very little of Aster's paperwork has been contentious.  We did have a small run in with the insurance company last summer when they told us that the diagnosis code for one visit was an exclusion.  The nice woman on the phone tried to get me to get my doctor to call for codes of similar but included diagnoses in the future.  I was too stunned (and too worried about the next-step specialist appointments) to argue on basic logic.  It makes sense that some treatments are excluded.  It does not make sense that an initial diagnostic visit might or might not be covered depending on what the diagnosis code at the end is ("You'd better not go see the doctor about that cough.  If the doctor decides it is bronchitis insurance covers the visit, but if the pneumonia box is checked, it's all you.").  This practice is even more ridiculous when neither patient nor doctor has access to list of excluded codes until after the paperwork for the visit (that may or may not be covered) has been submitted.
The bill I intended to investigate this evening was for three-hundred-some dollars for lab work in February.  I had previously received two EOBs (explanation of benefits) for seven-hundred-some dollars for this lab work (or possibly seven hundred some for the lab work and seven hundred some for the office that did the blood draw).  They each had different billed totals, stated that insurance was paying nothing and that I owed nothing.  So a three hundred dollar bill four months later is not much of a surprise.

None of this is anything new to anyone who has had a health issue. Medical bills that are impossible to correlate with actual treatments because of vague coding practices happen all the time.  Hospitals, doctors, insurance companies and patients all manage to screw things up*. However, given the number of visits and numbers of practitioners Aster may or may not see, the chances of hitting a screw up in any given year go way up, as does the possibility of a screw up having a cascading effect.

And then there is the school paperwork. And the legal documents that must be signed before we can see the school paperwork, every time.  And the early intervention forms in triplicate.  And the paper notices stating that I have been notified over the phone.

Compared to lots of kids with hemiplegia, Aster's files are slim.  He sees relatively few doctors.  His parents read English, have insurance and get along with each other.  This is not always the case.

CHASA has a few pages about financials and legal issues, should you want to know more about what other parents are facing.

*Dianthus's first doctor's mother stopped me on the street in our small West Virginia town, demanding payment (well, reminding me to pester the insurance company, yet again) one time.  It seems baby Dianthus needed medical attention before the insurance had records of him, because he could not get on the insurance roles until he had a social security card and he could not get a social security card until he had a birth certificate and the state would not send him a birth certificate until I signed another paper stating that Dianthus's father and I were married, as I had previously indicated on the application and approved on the draft copy of the certificate, yet had different last names.