Monday, October 12, 2009

Busy day

O...M...F...G...! Talk about annoying bladder-bumping! You know that sharp, gotta-pee-right-NOW feeling you get when Little One hits your bladder? Yeah. It's 10x worse when the baby's hiccuping and hitting your bladder each time. That's what she was doing a little while ago.

Cody's managers here went ahead and did a review. They managed to get some info finally from his old managers. The review they got from the old ones was just a bunch of number based on nothing, and they didn't even consult with Cody's direct supervisor, the guy who worked directly with Cody every day. That guy's pretty indignant that these managers, who couldn't even always tell which employee is which, would put together a hasty review on someone they haven't actually worked with without any input from the supervisors who so work with that person.

Anyway they had one minor complaint listed that the managers here said they strongly disagree with.

So the gist of it is that yes, Cody should have received a raise based solely on what they did send, and he should have received it before the review period was over, which was months ago. So he's going to see about getting back-pay for the raise he was actually owed which, by the flat percentage that was the raise for that review period (everyone who gets a raise in a review period apparently gets the same percent), this would be a nice little windfall.

And his managers here will be giving him a raise. We won't know for a couple days how much, and it's not so very common for someone so new at a location to get a raise, but they really are trying to do right, and we appreciate this so much.

We went and checked out a house. It's not spectacular by any means, and the backyard needs to be landscaped, but we'd be allowed to do whatever we wanted with it, if we can get it. Painting is fine, whatever, and it would be so nice to get to landscape a yard and put in a garden. It's also got a large, wood play structure. Oh, AND it's 100% animal-friendly. Hardwood floors except in a couple bedrooms, and the garage has black-and-white checkered flooring. Kind of cool. We'll be submitting our apps and everything tomorrow. Fingers crossed. If we can get it, we're out of here November 3rd or 4th. HELL YEAH!

I found a nice little loophole to get us out of the lease here without it hitting our credit. If management won't do anything about the people upstairs, and then try to raise our pet rent without telling us, etc., then I don't feel bad about using this loophole. Besides, they'll have no problem re-renting this unit. The 3br-units here rent so fast.

The insurance company is trying to deny coverage still for a birth center birth as well as for a midwife birth despite these being covered benefits on the grounds that my midwife is actually a doctor specializing in midwifery and that there is an in-network midwife in the area who does births at a hospital. Okay. Let's see. First of all, my midwife is not a doctor. I already verified that with the State of California's licensing board. She is a certified nurse midwife, NOT a doctor. So they are wrong there. Second, the midwife they said I could use only delivers at a hospital, not at home or a birthing center, both which are covered benefits. So they are denying a provider who can provide covered benefits saying she's actually a doctor, which, as I stated, she is not. Third, the hospital-midwife they found doesn't accept patients less than a month away from the window where they're expected to give birth which, for me is the week of November 11th (I'm due December 2nd, but expected to deliver at between 37 and 38 weeks). They're also still claiming that a hospital birth with a doctor is an option.

Fuuuuuuck that. A doctor would try forcing me into a c-section which, thanks to my intestine being adhered to the FRONT of my uterus, would very likely kill me. And any doctor at this point wouldn't be familiar with my medical history. I would have an unassisted home birth before I consented to letting a stranger hack into me to try cutting through my intestine.

So I am filing an appeal and, if they still deny it, I will have no problem whatsoever taking them to court. It is illegal for an insurance company to advertise a benefit as covered (midwives for home-births and birth centers) only to deny covering it in practice. If they state it as covered and there isn't a provider in-network but there is one out-of-network, then they must still cover it. To do otherwise is to deny coverage of a covered benefit. Of the many people I've spoken with at United, about half of them have said this themselves. Yes, I've kept track of names, dates, reference numbers, etc.. They must cover it.

I've got a lot of documentation directly from United that backs me up on this too. I've got a letter where they claim that my midwife is a doctor instead, and that also states that a midwife I can see is at a clinic...that doesn't work with midwives. They are not offering in-network options, and have stated that there are no midwives within 30 miles in-network who provide the covered benefits, but that a gap exception would be extended if I found one out-of-network who would. I've done what they asked, only to be denied.

If they do not agree to cover in writing before Charlotte is born, we will sue them in small claims for the full cost of midwife care as well as for punitive on the grounds of refusing to cover a service advertised as covered as well as for the emotional distress this has caused. Small claims is easier than unlimited jurisdiction, quicker too, and the cap for small claims is high enough to cover what we'd ask for.

3 comments:

  1. I hpe they come through with the backpay. If giving a raise of X% is their company policy then I'm pretty sure unless there was some maor complaint about him, they owe him that money. I'm sure it would come in handy trying to rent a house. Good-luck on everything!

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  2. The ironic thing is that using a midwife at a home birth is likely quite a bit cheaper than going to a hospital for several days and potentially getting a cesarian. They ought to be glad that you're trying to save them money!

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  3. And there haven't been any major complaints. Only complaints were when he wouldn't do something he wasn't authorized to do. Literally pull and peel back the bottom case like a sardine can lid to get out a stuck CD? (Actually happened.) Don't complain that he didn't risk his job by ordering a free repair when that intentional damage isn't covered by the warranties. Don't complain that he could fix, for free, a display that shattered when someone kicked it off the bed and it landed on its corner (another actual case). These complaints don't count come review time.

    Psych, I completely agree. Hospitals have a c-section rate over 1/3 now, and most of those are due to complications brought on by other unnecessary interventions, such as Pitocin-use when a baby hasn't come out in six hours. Midwife at home would cost less than $3k, which includes prenatal AND postnatal care. Base cost of a hospital delivery, presuming NO interventions are needed and discharge is within 24 hours of first walking in the door? (Which so rarely happens this way.) Close to $11,000.

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