Saturday, March 19, 2011
Want to try pushing a rock uphill? (an even longer and more boring version of what appeared in 'Chewing The Cud'!)
Time flies, but it also drags. We've had some qualified good news in that Lin's white blood cells have recovered sufficiently for us to pack our bags.
But we're still in limbo because he's now scheduled for a consult with the endoscopy specialist (this coming Monday) and until he's had his colonoscopy his feet are still nailed to the floor here in Singapore.
Thus far I have made some flight bookings and the ETD from Hong Kong is March 30th, 2011, with arrival in Ponte Vedra early April! Unless something untoward happens we should be able to make that deadline. It's the Singapore-HKG leg that is the moveable feast.
Prof. Wong is quite pleased that Lin has put on some weight. Unfortunately for me, I too have put on some weight - about 4 kilos since September last year! Must be the stress and keeping him company coaxing him to eat!
I have not been good about keeping all of you posted in recent weeks and I have wondered why. Is this experience starting to become tiresome? Yes, somewhat. Look at it this way, sometimes pushing a rock uphill calls for short rests!
But it is probably more about battling health insurance bureaucracy, in this case BUPA HK and the beady-eyed bods in their Claims Department.
After a hectic few months I settled down enough to put together the bits of paper we had accumulated from hospitals and such and sent them off for reimbursement. And that marked the beginning of a long and tedious trek to fulfill their requirements; the list of supporting documents looks simple enough at first glance. But be forewarned - or as we learn the hard way, get yourself a decent insurance broker.
Their claims forms are confusing (starting with trying to decide WHICH form is the correct form) and belie the amount of information that is needed - we have spent months shuffling from pillar to post to satisfy the Claims tartars.
Now I believe it when I read that doctors in some countries have quit practicing because of the amount of red tape they have to deal with in between treating the sick. That and the malpractice insurance premiums, no doubt.
In Hong Kong (and even in the USA) some doctors refuse to accept any form of health insurance - it's strictly cash, cheque, VISA or Mastercard. Or any combination of the foregoing. And I don't blame them having tried to walk the walk with the paperwork.
This saga began in September (about the time I started to put on weight so that puts the kibosh on me being fat when happy!). We had to appeal to have some claims accepted for review because some of our earlier bills missed the 90 day deadline for filing.
It seems most unfair that when one is least prepared to tackle (and has the least time for assembling and submitting) health insurance reimbursements is the time they must be in the clutches of the Claims Department. 90 days is too short a time when the family is dealing with a major illness or injury.
Anyway, getting hold of the same person at the end of the phone is like being in pursuit of the holy grail and Lin wasted much time recounting the situation to successive customer service personnel. In the end we managed (through divine intervention?) to transition to corresponding by email with the same person and that has been a help in recent months. What a relief!
I also discovered (who checks out these things when all is well?) that Lin's health insurance policy was being handled directly by one of Bupa HK's office sales staff with whom we had not exchanged a word with all this time (but probably earned a commission on having us on his books as a client), so long story short we switched to using an insurance broker recommended by a friend.
The only time we heard from this individual was when he emailed us to confirm whether if was Lin's intention to switch to a broker.
By the time that the switch was confirmed by Bupa the bulk of our claims were already in the pipeline so I continued rolling the rock uphill.
The system at the hospital means that we routinely obtained tax invoices and credit card charge slips. Having paid by Medisave and our credit card, we did not know to ask for the official receipts. Bupa would not accept the tax invoices accompanied by the credit card slips; they demanded receipts too.
And if we forgot or did not obtain an invoice when we left the hospital, we could ask for and were issued duplicate tax invoices at the next visit. These were not acceptable (Bupa seems to think that the presence of the word 'duplicate' means that their clients have tendered the originals to another insurance company!).
In the last month, the customer relations officer we have been liasing with at Bupa managed to contact the central finance and administration office at NUH and asked for receipts - that's how I learned where to go for them. What a revelation - it was the key log in easing that logjam!
Then, unknown to us, the Claims Department - a law unto itself - kept sending letters by snail mail to our Hong Kong address to ask for more details (despite us having spoken and written to Bupa to contact us in Singapore). These demands required that the submission be made within a month; not exactly easy when we do not receive our HK mail here in Singapore.
Anyway, another piece of mindless bureaucracy is the requirement that each claim must be accompanied by a letter from the doctor stating the diagnosis and the treatment! Surely any human being with a modicum of commonsense would accept that the diagnosis was made in April when the cancer was first detected - and had not changed.
As for treatment, surely that was obvious from the invoices and receipts which stated what was done. But no, the doctors have to provide covering letters.
In the end Prof. Wong wrote a letter summarising what had happened between May 24 and December, which he kindly provided. Thank goodness the Prof. has been most understanding.
Since then we have periodically submitted lists (signed by the Prof.) headed with the description of the condition followed by the dates and treatment or diagnostic tests ordered (all this merely repeated what the other bits of paper had to say).
Matahari would have trouble trying to make sense of the information on the Bupa Active part of their Web site pertaining to claims submissions. Prior to submission we complete forms that are not numbered. When these forms arrive in HK they are allocated voucher numbers and we do not know what numbers they might be allocated.
When the statements of account and details of submissions appear on the web pages, they bear ONLY the Bupa voucher numbers. Work that one out.
Dates make a difference too, we discovered. There are visit dates and invoice dates; and woe betide the client who is not detail oriented. Anal even.
I am math-challenged (2+2=5) and if not for spreadsheets I would have 'holey' pages in any book in which I try to keep accounts. As it is I delete lines and columns with great aplomb only to grieve later for their disappearance.
I can only imagine what it might be like to have my nails pulled out with a pair of pliers, but I feel as if I went through the mental equivalent in this trial and error experience of assembling our information in a form that would record what we obtained (with the information that we have learnt, step-by-error prone step - that Bupa requires), and then record what we have sent off to HK.
In the meantime they continue writing to our HK mailing address. Never mind cross purposes, we aren't even on the same channel.
Being inclined to be lazy and too reliant on Bupa keeping track, I now find I have to obtain and send them 'missing' receipts and invoices that I had ticked off lists that I had kept on scraps of paper! Better late than never, I suppose.
Our single sheet printer-scanner has never had to work so hard.
Thank goodness for the Bupa HK customer relations person who is caught between their Claims Department and us; while she is strictly a company person, she at least lends a human element to this whole farce. If not for her we wouldn't even have got this far in understanding how their bureaucracy works.
The 'war' is not over yet.
What still eludes me is the matter of which category in which to apply for reimbursements. There are subtle differences and I don't know enough to navigate through that maze.
Hopefully, our newly-appointed broker will bat for us in placing these where they are most likely to be considered.
In the meantime we appear to have surpassed the annual or total limits for some of the claims. Again it doesn't make sense because the benefit limit for diagnostics is really rather low so that when one has more than two or three scans and various tests, including blood tests, the budget's blown.
So how's the doctor going to monitor the progress of the treatment and to see if anything else is brewing?
If it's been boring and exhausting to read this, you can well imagine what it's been like to live it, all 4 kilos worth.
Posted by AWH at Saturday, March 19, 2011