Word to the Wise!!!

Ok, I almost wrote a blog about his a few months ago the THIRD TIME it happened to me, but now that it has happened a FOURTH TIME and concerns HUNDREDS of DOLLARS I am fired up enough about it to take the time!
Last time you had a medical procedure (childbirth, surgery, etc) and the doctor collected money from you upfront in what they call "ESTIMATED PATIENT RESPONSIBILITY" they collect your deductible and any estimated co-insurance. Then after your procedure, the insurance company negotiates a rate with them for the services (usually drastically less than their original charge), pays them their portion of the insurance and probably sends you a letter in the mail stating your "EXPLANATION OF BENEFITS" that includes your "ACTUAL PATIENT RESPONSIBILITY". Most of the time you've already had to pay the doctor so you assume its all taken care of, right? NOPE NOPE NOPE
Many times your ACTUAL PATIENT RESPONSIBILITY is less than the doctor collected from you originally because their rates and the contracted rates are different. Guess what? THE DOCTORS OFFICE IS NOT GOING TO CONTACT YOU AND LET YOU KNOW THAT THEY OVERCHARGED! NOR ARE THEY GOING TO SEND A RANDOM REFUND CHECK TO YOU IN THE MAIL!!!!

Ok, for example, here is how it has worked for us:
Collin had foot surgery. The doctor charged us $689.95 as our 20% portion of co-insurance. (this didn't even include a deductible b/c Collin had paid it elsewhere). After his first surgery the negotiated rate changed and our 20% portion was actually $209.79 as stated in our explanation of benefits from our insurance company. So where has our $480.00 been all this time? Sitting in the doctor's bank account waiting for us to call them and request a refund check be cut.
Why didn't we notice you wonder? Well I kept getting bills from anesthesia saying we had a balance due but I knew we'd paid everything already so I finally had to get out all the paperwork today and figure out the discrepancy...

The THIRD & SECOND time this happened was when we had Caleb:
My OB collected too much co-insurance also and we had to call them and ask for our refund that time too. At this point I got curious and started going back from all our expenses and noticed that our co-insurance on one of our sonograms was greater as collected by the doctor than our insurance said it should be in our EXPLANATION OF BENEFITS. Sure enough I called their office and they kindly said "Oh yes, you have a $40 credit, would you like us to send you a check?" Um, yes! Thats like half a week's groceries!

The FIRST time is happened (that I'm aware of) was when we had Caden:
Our OB collected our co-insurance and our deductible which I think was $500. After Caden was born, the hospital was the first to file a claim so the deductible was owed to them. So I had to call our OB's billing people and have the $500 refund check cut so that I could pay the hospitial. Once again they had no intention of letting me know I had a refund due and I'm quite sure that I would have paid additional out of my pocket without a word from anyone.

SO- do I have refund money floating around you might be wondering? Here's the easiest way to find out- logon to the webpage of your health insurance company and your can probably pull up a report stating all your medical benefits used and remaining for the year which will list out what your insurance company has paid and what you owe for each claim. Then compare what you paid to what your insurance company says you owe..
Or, even easier, if you have a particular doctor's office in mind, just call their billing department and ask what your balance is. In my experience, when you ask they are honest if you have a credit and will refund your money, but YOU HAVE TO CALL!

In conclusion, I understand that doctors often have a hard time collecting payment and I even understand why they collect upfront, But if they are going to do that, then I think it is their ethical obligation to refund money that was overcharged. Don't you? There is no telling how much money is floating around in the realm of underinformed who simply take bills at their word and pay whatever is claimed to be due on statements. Its too bad. It shouldn't take a stay at home mom with a Masters Degree and hours of time researching to get back what is rightfully money that belongs to me and my family. (and that we need to live on I might add)

I'm done, thanks for listening, if you get money back please let me know! Happy hunting!

Where's an Ark when you need one?

May I just interject that both of these are the complete work of my sweet, inventive little boy who has his own ideas about how his favorite animals should spend their day!

Favorite Song for now..

These lyrics have really inspired me this week, its a prayer for the people I love. I think first of my boys, but its my wish for all my friends and family too:

Be strong in the Lord and,
Never give up hope,
You're going to do great things,
I already know,
God's got His hand on you so,
Don't live life in fear,
Forgive and forget,
But don't forget why you're here,
Take your time and pray,
Thank God for each day,
His love will find a way...

I've added the song to a playlist add the bottom of the blog so you can hear it for yourself!

Costume Preview

Here are some costume previews from Annie's fun 2nd birthday party this afternoon...
Caden is the Yoda on the far right of the bench and Caleb is a cowboy, I'm standing up holding him on the left! So cute! Kids under 5 should have to wear costumes like once a week, its too cute for only once a year!

Pictures of Sonoma

Until we have time to do more, here are the rest of the pictures from our trip! It was wonderful and we are sooo blessed to have had the opportunity to go!



www.photoshopshowcase.com/Go.aspx?AID=256740&AT=3&VID=829686&ABID=788532

Video from the Beach

Here is a video from the beach on Thursday. We went on a vinyard tour this morning and had a lot of fun, but we forgot to charge the camera which was a tragedy. So... we just had to come back and take a nap while it charged, hurray for that. Meanwhile Grammy and the boys are at Sea World today, I'm not sure who is having the most fun!?

San Fransisco The Beach from Jennifer Bartley on Vimeo.

First Day in California

You'll forgive me for only posting this link, we are having too much fun to say more now!
http://www.photoshopshowcase.com/Go.aspx?AID=255559&AT=3&VID=826153&ABID=788532

Jennifer

Birthday Cake

We've been super busy this week! Birthdays and runny noses, bills and Bible studies, laundry and cleaning and cooking, organizing old clothes and getting out new ones, class reunion, cares reports, ministry meetings, doctor's appointments, getting ready for a huge trip to CA next week (more on that to come), not to mention tv shows to watch- sigh at Jim and Pam's wedding last night! Anyway, here are pictures of the most awesome Rainbow Cake ever...



but first, the birthday boy!

happy birthday to you...



happy birthday to you...


happy birthday dear Caleb...

HAPPY BIRTHDAY TO YOU!!!

Birthday Eve Updated with Videos!

Tonight is Caleb's birthday eve! We celebrated by opening some presents and started baking his fantastic birthday cake. As I type this it was almost exactly one year ago when we were driving to the hospital. Life is a miracle. Life is a blessing. I am thankful to the Giver of Life for what He has given me in my precious baby boy, thank you Jesus, You are so good to us!

A huge present box came today from Uncle Gray and Jenna!

Caleb thought these peanuts were the coolest! I guess you guys probably could have just sent a box full of wrapping...

...but it wouldn't have been so adorable as this!

opening presents from Jennifer Bartley on Vimeo.

Toys! from Jennifer Bartley on Vimeo.

Here is the awesome toy that we got in addition to a very cool A&M jacket. Notice the birthday card in Caleb's hand and the ball flying in midair, this is a really fun toy!

And tonight we opened presents from Grandpa and Grandma Bartley!

Caden helped!

Presents #3 from Jennifer Bartley on Vimeo.

Very cool little people!

Here is a preview of the festivities for tomorrow...this is only half the cake...check tomorrow for the end result...

Art Gallery

We are starting an art gallery here at our apartment...

This one is not for sale :)