Insurance Sucks

Well, we all know how much I hate Jon's insurance.   Strike 31277649374 happened today.  Today when I checked the mail, I got and explanation of benefits from our insurance company regarding a recent trip to Parker's pediatrician.  (You know, the one he's gone to since birth--the one that I was told by the insurance company was in network when I was 9 months pregnant.)  For some reason, the claim was only paid at 50% insead of the normal 80%.  So I called the insurance company promptly, considering they have the same cushy hours that the Social Security office has.  (Monday-Thursday, 9-4:30, and Friday 9-Noon) 

After a long hold, the insurance rep got on the phone only to inform me that the clinic that I've been taking Parker to for the past 19 months is not in network.  "SINCE WHEN?" was my heated response.  Apparently, they have never been in network, however, the stupid insurance company has paid all well baby visits at 100% since he was born, and all sick visits at 80%.  19 months into it, they realized their mistake, and instead of contacting me to let me know that they paid the previous claims at 80% by accident and that the clinic was, in fact, not in network, they just let me know by sticking me with paying 50% of the new claim.  JERKS! 

So, I decided to go right to the source and call Simmons' Benefits Director.  She went ahead and reassured me that the Northwest Pediatric Clinic is not in network, and that there are NO pediatricians in Fayetteville that are in network.  She informed me that none of her kids have ever been to a pediatrician, and that I can just take him to a family practice doctor of my choice.  (Idiot--pediatricians are pediatricians for a reason.  Family practice doctors are usually family practice doctors because they either did not want to deal with kids, or they didn't have the grades or drive to continue on with their education.)  She did however lead me to a pediatric clinic in Johnson, at the same hospital where I delivered Parker.  You know, the good kind with only 5 doctors and no after hours service whatsoever.  (Parker's current clinic has 18 doctors, 5 nurse practitioners, and is open until 8 PM, and from 8-noon on Saturdays) 

Oh, and the best part--She informed me that the owner of the company just takes his kids to the Northwest Arkansas Pediatric Clinic, and just pays the 50% charge.  (Said owner also has a house that covers a full block in Siloam Springs, a house in Colorado, a house in the Bahamas, a private Jet, and numerous other fancy pants cars.  Said owner has not been able to give my husband a cost of living raise in two years, and for the past year has not matched ANY of Jon's contributions to his 401K, even though in his contract it states that they will match half of Jon's contributions.)  WELL HECK, I'M GLAD SOMEBODY CAN AFFORD TO TAKE THEIR KIDS TO THE VERY BEST DOCTORS IN TOWN!  Simmons insurance can kiss my heine!