Tuesday, September 22, 2009

Into the Belly of the Beast

Current weight: 335 (I've kinda let myself go. I'm so ashamed.)
Current wait: 29 days and counting

So I'm a month away from the big day, the day I say FU to F-A-T, and I'm feeling pretty good about myself right about now.

It has nothing to do with the six pieces of bacon I had for breakfast. And no, I have not suddenly had a self realization about my body image issues after spending the entire night standing in front of a mirror naked chanting "I love my fat folds" over and over again.

Why then, my bellyrific buddy are you so giddy, you ask. Is Denny's giving out a free stack of pancakes with every order of Moons Over My-Hammy? Did Ben and Jerry's just come out with a fat-free, calorie-free cheeseburger flavored ice cream called "Cheeseburger in Paradise?" Did Vogue just declare fat, sweaty and out of breath the new black?

No, friends, none of the above. But those are all good guesses.

Last week I spat in the face of the school yard bully. I hurled a rock skyward with my trusty slingshot. I donned my best Rocky Balboa getup and stepped into the ring with Apollo Creed - The Count of Mighty-fisto! Yes, that's right. I dared to question the Insurance Industrial Complex.

What?? You'll get murdered to death! At best you'd be left bleeding profusely while laying in a variety of your own bodily fluids.

Yes, I knew I was taking my life into my own hands a few days ago when I called the AETNA Fat Police to question some recent insurance charges. But guess what? I'm still standing. In fact, I'm standing here victorious, proudly holding high one of the North American Tag Team championship belts.

Dramatics, hysteria and hyperbole aside, lemme 'splain.

I recently got an Explanation of Benefits for my EGD procedure in July. On said EOB, the charges from the facility where I got my gut checked were billed out at 60 percent, meaning the number listed under the Total Patient Responsibility was a whopping $6,300.

W ... T ... F?

After peeling myself off the ceiling and putting my eyeballs back into their sockets, I placed a rapidly frantic call to AETNA to ask what is the BFD? Seems that the facility is out-of-network (thus the 60 and not 90 percent) and nobody bothered to tell this guy.

I entered into this thing with the understanding that The Good Doctor was in-network and all of this was going to be covered at 90 percent up to $1,000 maximum. Meaning, my total out-of-pocket for this here deal would be no more than a cool grand.

But Holy Fat Farm, Batman. Sixty-three hundred dollars? That queers the deal right there. If I'd have known that, I would have been right back to eating rice cakes and lettuce wraps because that particular portion of bodily waste ain't gonna soar gracefully through the air.

Now, this is the same facility where I'm scheduled to have my surgery, so naturally, I asked if the upcoming procedure is only going to be covered at 60 percent. No, the nice lady said, this facility has been approved as "in-network" for this procedure and will bill at 90 percent.

Again, say it with me now, W ... T ... F?

That makes no sense, I argued, that this facility is first out-of-network for a procedure that The Good Doctor ordered, but later approved as in-network for the larger procedure.

Well about 45 minutes and 4 or 5 transfers later, I ended up on the phone with a bigwig at the facility. After calmly (which took a bit of doing on my part) explaining my dilemma, she graciously apologized and said not to worry, that I would not be held responsible for the charges and to let her know if I get any bills stating otherwise. She even gave me her cell phone number.

After this time picking myself up off the floor and snapping my dropped jaw back into place, I thanked her, hung up the phone and stood there dazed for a second. Then I did what a crowd of anxious onlookers would have done had they been listening in for the duration. I gave myself a slow-clap ovation!

Now, regardless (or irregardless) the reason, be it someone made a mistake or the facility decided to eat the costs knowing good and well that on the horizon they were going to get paid, and paid well, for my upcoming procedure (I'm guessing the latter), I still declared myself Supreme Insurance Fighting Heavyweight Champion of the World.

Which is fine until I have to get the championship belt re-sized in about a year.

Peace, Love and Nutter Butters.

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