Saturday, September 12, 2009

a Mad Lib We Did Tonight: "Samson & Delilah"

Samson & Delilah (a tragic dialogue)
Delilah: Sam Samson! will you stop doing those itchy excercises?

Samson: Listen, Delilah. I have to keep my scumsuckers in shape. After all, i'm the strongest penguin in the tribe.

Delilah: Well, you look sexy. Look at the way your hair hangs down over your condom machine.

Samson: I've been busy. Yesterday I had to kill 10,000 Philistines with the jawbone of a panda bear.

Delilah: Sheisty fuckface! you promised to take me to a robust party tonight!

Samson: okay. So I'll tickle my hair.

Delilah: I'll do it for you. Now just here on this penis-head and I'll give you a silver haircut.

Samson: Okay.

Delilah: There. Your eyeball is nice and short. How do you feel?

Samson: Clammy.

Thursday, September 10, 2009

one of many recent health insurance emails

THEM

Dear Ms. Robin:

Thank you for using the Aetna Navigator website to contact Aetna Member
Services.
This is in response to your claim question on you for 04/10/2009 for the
amount of $8,844.35 from _____________.

The above claim was processed towards your in-network benefit deductible
of $300.00, and then paid at 80% leaving your patient portion of 20%.

The total patient responsibility is $1,106.74 including the $300.00
deductible. The insurance paid the amount of $3,226.99.

Please refer to your plan summary of benefits which covers outpatient
hospital services at 80% once the $300 individual deductible is met.
Outpatient diagnostic, x-ray or lab services are covered at 80% once the
$300 deductible is met.

Our records indicate that ______________ participates with
your plan of benefits and the negotiated allowed amount for your service
was $4333.73.

The adjusted amount of $4510.62 (the difference between the submitted
amount of $8844.35 and the negotiated allowed amount of $4333.73) is a
provider write-off. You are not responsible for this amount.

We have processed your request for an Explanation of Benefits for you
for the 04/10/1009 date of service from ___________________.
You should receive a copy in the mail in 5-7 business days. You may
also print an electronic copy of your Explanation of Benefits from your
Aetna Navigator secure member website.

The electronic Explanation of Benefits looks exactly like your paper
EOB. Both versions include service date, provider name, bill expense,
amount not covered, remark code (if applicable), etc.

If you have questions, you can reach Member Services by (blah blah blah).

Sincerely,
Internet Response Team


ME:

Okay, for starters, whoever you are that's writing me back, I understand that you are just a person, like me. But right now, I feel like I'm dealing with crooks -- not you personally, but AETNA. "$8,844.35," "$4333.73," all these numbers you're telling me, they all could've just come out of nowhere for all I know, because nobody told me any of these figures before I went in for that MRI. Do you understand how unfair this is?

So what I need you to do is to please kick this issue up to a higher department at AETNA. Because I have a real problem with the way AETNA is conducting this matter, and I'm not going to let this rest. I am very involved in advocacy and healthcare issues and the way Health Insurance companies conduct their business, and I need my own issue resolved satisfactorily.

Thank You,
Robin

AND THEN:

THEM:

Thank you for using the Aetna Navigator website to contact Aetna Member
Services.

This is in response to your claim question on you for 04/10/2009 for the
amount of $8,844.35 from ________________________.

Your claim has been paid according to your plan benefits.

You may use the "Estimate the Cost of Care" option on your Aetna
Navigator. You may do so by mousing over "Take Action on Your Health",
then clicking on "Cost of Care". Here you will find the average
contracted rates for procedures such as a MRI. Another option is to
contact Aetna prior to services performed. Provide us with the
physician or hosptial information and the procedure that will take place
and we can provide you with the necessary pricing information.

If you have questions, you can reach Member Services by logging on to
www.aetnanavigator.com and selecting "Contact Us". You may also call
the toll-free number on your member ID card.

Sincerely,
Internet Response Team

AND ME:

Yes, but it is too late for this information now that I already have a bill for over $1,000. Aetna needs to have a much clearer protocol in place regarding the cost of medical procedures. My cardiologist told me I needed an MRI. I had no idea I would have to ask AETNA how much this procedure costs before telling my cardiologist "yes, I will take your advice to have this potentially life-saving test you are telling me I need." I have never before had such problems with any insurance. As I say, this whole correspondence needs to be made available to a much higher department than Member Services, because this is a big problem, AETNA's lack of a followable protocol for its members who pay so much money for AETNA's coverage.

I need better customer service, better answers, better corporate accountability from AETNA.

-Robin

then i printed this all up and sent it to the ceo at aetna's corporate HQ with this at the end of the letter:

What I am getting at here is the fact that your company purposely makes your policies vague in order to, in your opinion, justifiably give your clients figures for what you are and are not deciding to pay for procedures. But it is not justifiable. I had no idea I would have to pay over a thousand dollars out of pocket for a necessary MRI, and if this is the case with your policy, you need to send your customers warnings regarding the possible out of pocket amount, because, as I know your corporation knows, the layman does not understand things like this. Your company needs to get a social conscience.

Because of your purposely vague policies, I now have to prove to Cedars Sinai that I am unable to pay this money, being that my whole household is unemployed, and hope they write me off as a charity case. But that is not why I am writing to you.

I am writing to you because you need to put a more user-friendly protocol in place, ASAP, to stop ripping off your clients. There is NO WAY it would occur to someone, after being told they have to have a necessary medical procedure, that they have to first "use the 'Estimate the Cost of Care' option on [my] Aetna
Navigator. [I] may do so by mousing over 'Take Action on Your Health', then clicking on 'Cost of Care'" to find the "contracted rates for procedures such as a MRI," as your customer service representative belatedly informed me.

What is your excuse for all of this?


why am i telling you all this? a) unfairness is, unfortunately, my obsession, and this whole thing feels unfair to me and b), i really do think that these companies try to confuse us on purpose, and it's not right.

Monday, September 7, 2009

starting a blog

my name is robin. i am a 30 year old unemployed, married chick living in a penthouse apartment in hollywood. yesterday afternoon my husband & my dad & stepmom were listening to me whine about how, basically, i peaked, creatively and punkly, etc., when i was a teenager. when i was a teenager, i even got some of my teachers to buy off on calling me by my nickname of "princess robin." i did a pretty well known zine and had a pretty well liked riot grrrl punk band. girls who find me online now who knew me then sometimes tell me that, like, i changed their life, exposed them to cool stuff they are still into, etc. i had chutzpah (sp?), you know? if something was unfair, i would yell at the grown man who was making the shit unfair until he backed off and apologized to me and the other teen girls involved in these showdowns. it felt glorious. but, i don't do anything now, worthwhile, you know?
I'm a fiction writer and poet, and have been forever, that's been my only real thing i've ever cared about as a career path (besides wanting to be a hero, like a vigilante or something), but i can hardly get anything published. i have five or so stories published in online or print literary journals, and this is after submitted to probably 30 journals a year since i was 19 -- you do the math (no really, will you do the math? i'm awful at math. but those figures sound bad).

my husband & me went to philly so i could get a master's degree from an ivy league school and guess what? -- a Master's Degree is a liability on a resume, turns out! at least when you are trying to apply for secretarial positions, like i always end up doing, because that's all the professional experience i have.

i'm reduced to whining, feeling sorry for myself, and trying to sell scarves i make online.

but i wanna be princess robin again, ya know? i wanna kick ass and take names & make a difference and for people to read my work again the way they used to when my zine had a following all those years ago when i was an itsy bitsy 13 through 18 year old wearing old gym socks over hairy legs with vintage dresses and my crazy teeth. well, i still sorta look like that, only now i have a chest full of crazy scars too.

but anyway, i wanna shine, like a moon. life should mean something.

i just saw my friend biz's blog about being homeless and having adventures and i thought, i will give blogging a try.