Insurance Rant #45982710

I received the medical bill for M's emergency room visit in January. It was quite a bit more than I thought it should be. Per my insurance, I pay a $150 co-pay for an emergency room visit, and an initial co-insurance of $400 per person. When I read through the bill, my co-pay was listed as $300.

I called my employer and was told that my insurance had made the determination that my emergency room visit was non-emergent and therefor I was being charged an additional $150.

Um....Say the Fuck what?

Children die every year from MRSA sepsis and my child was now on day three of fevers, spreading wounds and an abscess that was threatening circulation to his right leg. This was on a Sunday night, after office hours and after urgent care hours. How is this not emergent? Should I have waited until he was non-responsive, lethargic with other vital sign changes before bringing him in? The doctor was concerned that M might need to be admitted to the hospital. This wasn't urgent?

So needless to say I am launching an appeal and complaint. (1) It should not be up to the insurance company to look at a billing code and decide whether or not the care was warranted and (2) if my child's physician tells me to take my child to the emergency room I should not have to question whether or not my insurance will concur with his direction.

I'm not sure I will win this one, but I will fight tooth and nail for it. The thing that ABSOLUTELY SUCKS is I work for the hospital system that's screwing me and, if I refuse to pay, they just take it from my paycheck.

This just might be a catalyst that makes me look into pulling the kids from my insurance and having them cared for by the tax payers. As horrible as that is, I see no choice. I am trying to do the right thing and yet I am drowning in medical bills. This plain sucks!

***I have no idea why this post is formatted weird. I have tried to fix it with no luck***