Monday, January 25, 2010

Health insurance fun

Apple carries UnitedHealthcare for its employees. It offers several different plan options, but because we live far away from any metropolitan area, our coverage, even with the highest level plan, is often -- spotty.

For example, Provena Covenant is the UnitedHealthcare hospital in town. But very few Provena doctors are actually UnitedHealthcare doctors. There are several Carle doctors in many specialties, however, that are in-network UnitedHealthcare doctors, so, go figure, we go to Carle Hospital.

Any blood work that is done outside of the hospital must be done at a United Healthcare-approved lab or UHC will only discount the adjusted rates -- i.e. the labwork won't  be covered. And, of course, neither the Provena or Carle labs are "approved."

Well, they finally opened an approved lab in town a couple months ago, so blood tests should no longer cost us between $200-350. We went to the new lab today for the first time for my follow up blood tests. The Alverno lab is in the basement of this very depressing office building on the corner of Springfield and 6th street in Champaign. It's underneath something called the Wrestler medical clinic (Wrestler is the doctor's last name -- and he appears to do all kinds of specialities per the signs on the doors).

The person who did my blood draw was nice, but when she went over where the results should go, she'd never heard of Carle and didn't know where it was in town, because she lived 90 minutes away and only drove in for work. "I don't actually spend any time here, and I know nothing about this place."

Yes. Totally weird. Sketchy. Bizarre. But I was the 14th person there today, per the sign in. The vials and needles were all in sealed packaging (hell yes, I checked) and it looked like they just took the blood and fed exed it to a lab -- probably in the burbs and then took care of the results afterwards.

As it is, I have my follow up with my surgeon on Friday, Jan. 29 at 3:50 p.m. Well see how that all goes.


Debra said...

That is quite interesting considering when I get bloodwork done for myself or the boys at Provena and they don't process it correctly with our insurance... I get a bill from... you guessed it: Alverno Labs.

I hate how complicated insurance can be. Just sayin'.

makeup_girl said...

Verizon just switched to Blue Cross/Blue Shield starting this year. Now I have to fill out all new paperwork anywhere I go. *sigh*
Although I am going to guess you'd rather do that any day than deal with your insurance restraints any day.

Looseyfur said...

Makeup_girl, who takes Blue Cross/Blue Shield? When Joel and I first moved here we had it, but Carle Clinic wouldn't take it... do provena and christie?

Debra, Joel did some research. Turns out Provena and Alverno are business partners when it comes to running the lab. But my guess is UHC only contracts through Alverno -- and when they mess up yours and don't run it through Provena is when you get charged by Alverno.

It's like 3 hands in 2 million pockets...

makeup_girl said...

I'm not sure if Carle takes it. We have always been at Christie/Provena, and when we switched I was worried. But all of our docs take BCBS, so we didn't have to find new ones.

Debra said...

So if alverno can bill you then it makes no sense to me why you can't go to Provena and have them bill you through alverno. It just doesnt seem complicated to me. But apparently I am "too simple" for such things...