A clean hizzy...and just plain, gettin' bizzy!

Wow! So I've totally been slackin' on my own blog. Not sure what I've been up to, other than 1) growing, 2) trying to get my nesting activities organized, and 3) celebrating my birthday! This baby will be popping out in 4 months and baby-prep is in full swing!

One large item on my long to-do list was to organize all of my medical bills, insurance EOBs, and track all of my medical expenditures to date while projecting how much I will need to set aside for the remainder of the year. While I'm hyper-organized anyway, this is an excellent activity that everyone should do, whether you are pregnant or not. Especially today, when the federal healthcare reform issue is on the table (again), it is so important to understand what/how you individually may be affected by these plans. (Most of us may remain unaffected, but still...health care and the way you are billed by your provider and how that translates when an insurance company is involved is a complicated process. I do not claim to understand it fully.)

For example, one of my latest checkups involved an optional blood test at the 16th week of my pregnancy for some development abnormalities. (I think some of these included spinal abnormalities, etc. I can't remember exactly.) While a test like this is optional, it sounded routine, so we decided that I should take it. Well, the bill from the laboratory that processed my test came and this particular test cost $768. I was completely astounded. But I was further astounded to also see my Insurance claim arrive for this test. My test was covered (thankfully), but my insurance carrier covered only $48.50. Yes. $48.50. Forty-eight dollars and 50 cents. Excuse my french but, WTF?

The laboratory accepted that meager payment from my insurance carrier as payment in full. So, I am off the hook for that bill, but where did this $768 dollar figure come from? In my elementary understandings of the ways providers bill, a health service (be it a visit, a test, what have you) costs x amount. Depending on whether or not you have insurance or are on medicare/medicaid, the provider charges you a factor times x. For instance, since I have insurance, I may be charged 1.2x. If I didn't have insurance, I may be charged 1.5x. Someone on medicare might be charged 0.8x. Somehow, this all makes sense in the health providers balance sheet. They have to charge certain patients more to make up for where other patients lack.

Does anyone else out there understand this?  Nesting is in full swing as I've also been trying to tackle other baby related issues such as my baby registry and daycare.  Those are kinda biggies and definitely warrant their own posts.  I have also been cleaning the dog (sorry, Clyde!) out of my house.  Feeling a little on the obsessive/compulsive side about this, but I'm sure it is just my nesting jones coming out and dealing with just the general need to be prepared.