Stressed!

Before I start this story you have to know prior to this day I called the insurance company several times to find out if different ped specialist were under our insurance. Most of that time was a waste because most of the peds under our plan were booking many months away. So the story begins....
I was very excited to get the news that the pediatrician was able to get Max in to see a specialist at the end of June. I decided to call the insurance company to make sure they would cover his evaluation. The first lady from the insurance told me the physician he was going to see was not in network therefore I would have to pay the entire bill. I was sure this would be more than just a normal office visit charge since they do a 2-3hr evaluation. I couldn't believe my insurance as an RN covers 0% if you use out of network providers. That led me to call work to talk to someone from human resources. Sure enough our insurance covers 0% if you go to someone out of network. So I then asked her to tell me what specialists he could go see. She tells me that the Dr. he is scheduled with is in network and is unsure why the insurance lady told me he wasn't. That led me to call the insurance comany again. They tell me as long as they bill under the Dr. it will be covered but if they bill under the clinic it may not be. That leads me to try and call the clinic but I guess since its new and the staff travels to different clinics in the area the people are not at that location at the time I call. I spend over and hour trying to get ahold of the actual clinic before I get told they don't charge under the Dr. it will be charged under the clinic. So I call the insurance company back and they can't find that clinic in or out of network so they will need me to call clinic back to get the tax ID #. I then have to leave a message for someone who will have to call me back. Get a call later with tax ID #, call insurance back again. I have to talk to a machine every time I call the insurance company back, put in my account info every time and I get a new person every time I call. Guess what.. the tax ID number they gave me is not covered under our insurance. I finally tell the insurance company that I don't understand that if the Dr. he is going to is in network and the hospital that the clinic is under is in network why it would not be covered. They just "really aren't sure". I then not so sweetly explain to the insurance company they need to call the clinic and figure it out then. I explain to them that my child needs to be evalauted for autism ASAP and that if he can't go to this appt no one else can see him until the end of Sept. After wasting three hours on the phone that day and speaking to everyone at Cigna I get told by the last insurance lady that she "thinks it might be covered and if not I can appeal it". Fabulous! I am so glad I pay taxes and pay monthly to have this great health insurance!