Science fiction, fantasy, mystery and what-not
I’m a retired military veteran and over sixty-five years old. That combo means my health insurance is through a hybrid product that requires me to sign up for Medicare A & B when I turned 65. Mediacare provides primary coverage to me and my wife; TriCare for Life (TFL, officially known on the web as TriCare4Life) gives us secondary coverage. It’s not a bad deal. It isn’t free; my wife and I both pay for Part B.
What made my coffee taste more bitter than usual was a bill from my provider received this month. They said I owed them over a hundred dollars for lab work and that TFL hadn’t paid anything. Egged on by my other, that sent me into a tizzy of indignation. A website I found said, yep, TFL doesn’t pay for preventive lab work. This made no friggin’ sense and only urged me to greater outrage.
I logged into the various systems this week to find answers. Not finding satisfaction there, I was forced to *gag* call them and speak to people. I have nothing against people or talking but I dislike phones and bureaucracies. Girding myself with a mug of stout dark goodness, I called T4L. After providing evidence of who I am and waiting a few minutes, I was connected to Derek.
I explained it all to him and proved who I am to him. Derek began ferreting through the systems for more about my grievance. I logged into my provider portal and dug out more details. Shame on me, but only then did I realize that this bill was for services from May of 2022. That just seemed wild that I’m dealing with that over eighteen months later.
Derek looked into it and discovered that T4L didn’t pay it because Asante, who did the work, didn’t send an EOB for the Medicare part that was paid. “Have more coffee and call the provider,” Derek advised.
Thanking him for his assistance and wishing him a good day and Merry New Year, I did so. After providing evidence about who I am and a short wait, Karen heard my tale. “Interesting,” she said. “We show that T4L denied the claim.”
What?
She went on to tell me it’d been rejected three times and that’s why they were now billing me. “Let me contact the insurance section and confirm they sent the needed EOB,” she went on. “I’m going to email them now.” She typed away while I listened to keyboard clickety-clack. “There,” she said. “Now we’ll see what happens. Your bill is due next week but ignore that. If you get another bill or notice asking for payment, give us a call to check on the status, okay?”
Sure. I thanked Karen, wished her good day and Happy New Year, hung up and wrote up my notes. Now I wait, but I feel optimistic about the outcome. The whole thing only took one hour.
I couldn’t have done it without coffee, though.
Mood: peckish
December 29, 2023. Today is Friday, and it’s a wet windy time in Ashlandia, where the New Year Eve celebration preparation is below average. 59 F degrees right now, 61 F has appeared on the offerings board as our high. It’s like winter has declared a moratorium on snow in our valley, and the mountains around us. While it’s nice for now, we need the snowbank to be replenished.
The cats are happy, though. I let them out and they settled on the covered porch, leisurely surveying their kingdom as the rain fell, yawning, washing, then drowsing. Tucker stayed out but Papi banged for re-entry to get some sugar from me and have a third breakfast.
No serious plans for NYE in our house. We looked for dancing and dining opportunities but nothing called the inner rocker. Seriously, the pickings were lean as a wheat crop in the Sahara. So, shrug, it’s a quiet evening planned for us. Neither of us seem overly upset over it.
The Neurons fed a Triumph song, “World of Fantasy” from 1983, into my morning mental music stream (Trademark fantasized). A convo with the significant O opened the portal for the song. We were talking politics and how some seem to live in such a fantasy world. I was later humming but didn’t quite recognize what it was. Later, in bed, the song came more deeply but I still couldn’t hook up with the title or band. Come morning, while downing coffee, The Neurons tipped that it was Triumph and “World of Fantasy”. As I remembered it, I thought how Triumph, a Canadian group, sometimes reminded me of Rush, another Canadadian group.
Stay positive, be strong, test negative, and lean forward a better future. Coffee has been sucked up and is yielding positive results. Here’s the music for you. Cheers
Michael Seidel, writer 