Tobie here: Grab a drink. Long post coming here. I’ll try to go in order of events.

My b-day was this weekend. Let’s just say it went along with all the other Holidays this year. But yea! Happy b-day to me!

Okay on to bigger and better news! The sex of the baby was determined this morning. First of all, going in order of events….my cervix is still nice and long. Go cervix!!!! Thank god. Okay, okay, moms are always instinctively right….we’re having a boy. Yippee! I would have been happy either way, but my gut led me to believe it was a boy from the get-go and I’ve been referring to him as a him all along (and calling him by his not-yet-released name).

Next appt today: peed appt : 9 month eval. Let’s start with Paige as she is so predictable. Our fab doc has a nifty computer program that plots all measurements and graphs them for both adjusted and corrected ages. Paige currently weighs 18lbs, 13 oz. Yeah, this is odd as she was much heavier a couple of weeks ago at her neuro-developmental appt. Eric and I have decided their scale was off. Anyways, with her new weight she is absolutely perfect (like we didn’t already know that). So no change will be made to her diet. Actually the peed said she’ll be on whole milk starting in January. What?!@# No more formula? This is exciting! Of course, she’ll need to see her ENT to confirm she can come off the thickener, but every doc thus far is saying she’ll have big changes starting in January. I think having cereal in everything you eat and drink has got to be disgusting, but since she doesn’t know any better I guess it’s manageable. Last Paige event: her teeth. We’ve all seen her cute bottom teeth so the next teeth to pop through should be her two upper teeth according to the tooth eruption chart. But of course big girl has to be different. She’s getting her two bottom teeth next to her existing two teeth (that’s four bottom teeth). Go figure.

Cole. He’s still small. 15lbs, 4oz. The Peed doesn’t recommend tubing him at all. In fact, strongly against tubing. Of course, it’s still up to convincing the GI doc, but the more people who say don’t tube, the better. What we’re going to do instead of tubing is put Cole on the ice cream diet. Yes, don’t we all wish we could be on an ice cream diet! I am serious about that. Which will be great for Cole as his bottom teeth are poking through (one’s already through, the other right behind it), but he’s still gnawing on everything in sight. We also can start giving Cole mashed potatoes loaded with butter, yams buttered up, and pureed meats (not baby food). Yes, Thanksgiving will be very tasty for the babes. Why does this excite me so much? I think that’s all for Cole.

Lunch. I met my bestest bud Nic and her wonderful sister for lunch today. Of course we had lunch on a patio for germ’s sake. Paige was an angel as always. She sat in her car seat and laughed when us girls laughed, and made raspberry sounds intermittently to keep us entertained. I forgot to mention that she learned how to make the “Pppffhaa” sound with a lot of spit last week and now makes that noise 24/7. Seriously in the middle of the night I can hear her over the baby monitor cracking herself up by making that noise. It’s hilarious! Getting back to the lunch. So Cole being typical Cole decided to take advantage of an all-girl lunch and get his flirt on. He started off on my lap but then was reaching for Nic and making googly faces at her so she held him for a while. The chemistry between them dissolved when he puked all over her. Luckily her sister was done eating and volunteered to hold him so I could finish lunch. Mr. Squirmy Wormy was smitten with her. I think he was in love. He sat perfectly still in her arms and just stared adoringly at her the rest of the lunch. I had a lovely time (thanks Nic for the invite).

Lastly, Eric’s dad and his wife are here for a week. I’ll let Eric post about their visit when they leave but it’s been great thus far.

We had another OB appointment yesterday. The baby looks great and is doing well. This was also the first appointment where we measured Tobie’s cervix. Looking long and great as always. Is there ever TMI in this blog? We were hoping to get a look at the baby’s goods to determine which clothes we can give away and which we need to keep (okay there is very little we can give away because we’ve ruined just about every piece of clothing). It’s a little too early to tell the gender, but we should find out in a few weeks (I think we are doing weekly OB visits now). What do you guys think we are having?

Tobie also got a flu shot while there. What would be the odds of Tobie having an adverse reaction? Yeah, she was sick all night and all day today. I’m telling you, we have the worse luck with side effects. She’s starting to feel a lot better tonight, but is very very run down. Luckily her family came over and played with the babies all day.

Okay, rant time. You might want to go read another blog.

Our health care system sucks! There I said it. It’s just that simple. Since I know this is a family oriented blog, I’m going to refrain from bad words. Tobie and I are college grads. I think we are pretty intelligent. I’ve had the damnest time sorting through all the medical invoices since this whole ordeal began last year. We’ve submitted over $2 million dollars in medical claims since December 2005. Insurance has paid a little over $1 million because of their negotiated rates. What the heck, if we didn’t have insurance I would have to pay more out of pocket than the insurance company? That doesn’t seem right. But I’m getting ahead of myself, let’s start back at the beginning.

So we switched insurance plans at the start of the year because Tobie’s employer went to a new employee driven plan (which ended up costing us sooooo much more money, but I’m not going there). Fine, but we had already started our hospital stay in December. At that moment I knew it was going to be trouble. I can’t tell you how much time I had to spend calling each insurance company and the hospital trying to figure out who owes what. We had a $80K bill for Tobie’s hospital stay. The first insurance company picked up their portion, but the new insurance company refused to pay the remainder. Do you know what happens if your insurance company refused to pay a bill? You get very very scary bills in the mail saying you have 10 days to pay $33K. I had to go on a payment plan with the hospital to avoid collections while the insurance companies duked it out. Who has an extra $1500 a month to pay the hospital?? Not me. So each vendor would tell me something different. I don’t want to say they don’t know what they are talking about or are lying, but it seems like every vendor’s first line of response is to say it’s not their responsibility and blame the other guy. However, once we got Tobie’s HR department involved (as a last resort), the outstanding $33K bill was paid, albeit 9 months later.

And what the heck is with all the mail we get from the vendors and the insurance company. Why are you sending me an invoice that says I owe a certain amount and then so kindly at the bottom of the invoice say “This is not a bill“. What is up with that? Do I pay it? Do I let it be? Could I have anymore uncertainty hanging over my head? Can you imagine how many pieces of mail we have received? In fact we’ve received so many bills that if we don’t pick up the mail from our mailbox for a few days, they stop delivering it. Seriously, who uses mail nowadays anyways. It’s all about online payment systems.

I cannot tell you how many times I get second and third notices from medical vendors wanting their piece of the pie. I can’t tell you how many times I’ve called to pay my bill and after further investigation from their billing department, they say “You don’t owe anything right now, there were some claims that weren’t submitted to the insurance”. Seriously, do I owe you money or not? This is the reason I wait until I get the red invoice that says we’ve been sent to collections. See, we have to pay a deductible for the insurance plan (actually we had to pay two since our insurance company changed during our hospital stay, but I’m over that, seriously I am). Now one would think that I would just pay the deductible to the insurance company in one nice big fat check and they would make sure everyone else gets paid. Nope, I have to reconcile every bill with the insurance company to make sure I owe whatever amount the medical provider is charging, up to my total out of pocket expense. See the medical provider can’t say: “You owe this amount because it’s part of your deductible”, but instead tells you: “We’ve filed some claims and you owe this crazy leftover amount now“. Do you know how time consuming this is? I have an accounting degree and I’m lost in this exercise (okay, I was 2 classes shy of getting my accounting degree, but that’s neither here or there).

Onto COBRA. Who on earth coined that acronym (I blame the Republicans. Let’s get them out of the House..oh wait, nevermind)? COBRA stands for: Consolidated Omnibus Budget Reconciliation Act. I know, sounds sexy. I could have thought of something more identifiable with our situation. Like Long-term Health Coverage (LHC), or Not Working But Still Needs Health Care (NWBSNHC), or No More Employer Paid Premiums (NMEPP), or Now You Are Going To Pay Up The Ass For Health Care (NYAGTPUTAFHC), or Health Care That Costs More Than Your Mortgage (HCCMTYM), or Snakes On A Plane (SOAP). We’ve been on COBRA since Tobie gave notice at work. Well that’s not entirely true, apparently I didn’t pay the premium to the COBRA administration company the day after her last day. Oops, that’s my bad, but as soon as we realized we needed to pay them, we did and the story unfolds.

Basically there is a company that administers the COBRA insurance. What does that mean? Each month I send them payment and they forward it on to the insurance company? Yeah, you heard me right, they take my money, deposit it, then cut a check and send it to the insurance company. How do I get that job? So I go online and they have a little calculator to figure out my first payment. I send the check via mail. Apparently I send it to the wrong address because on the stub they ask you to mail in, it’s missing part of the address. Super!

I give them a ring and tell them I don’t think the address was correct on my payment. They have no idea what I’m talking about. In fact, they have no idea how I arrived at the amount I sent them. Instead of arguing, I just FedEx a check to them and they tell me it will take up to 48 hours to process. Apparently we’ve been going to doctor’s appointments without insurance. Oops! I can’t wait to reconcile those bills.

So flash forward to the next week, which is this week. All the doctor’s offices are saying our insurance is canceled. Oh, this cannot still be happening to us. I call the COBRA company to see what’s going on. Apparently it takes 5-7 business days to process a payment once it’s received. Seriously, that’s not what I was told the first time around. I inform them we have multiple doctor’s appointments every week and we need this processed quickly. Their response: “Oh you have doctor’s appointments? We’ll just put the standard rush on it and your insurance company will have you in their system again in less than 48 hours”. I guess sending a FedEx with payment and telling them I need this processed ASAP didn’t warrant the standard rush! I ask them what about next month. I’m now setup with direct deposit so I figure everything from this point on will be pretty seamless. No so fast. Apparently there will still be a 5-7 day delay before my insurance company will have payment, so technically I’ll be without insurance until payment is received. I asked what if I have doctor’s appointments the first week of the month. Their response: “Try not to schedule doctor’s appointments around the first of the month, but if you need to see a doctor, please call us and will put a rush on your payment”. Why can’t I just make a payment to the insurance company directly? Why can’t they just put a rush on it every month? Why is this overly complicated? Once again, the system seems broken.

In closing of this rant, do you know what happens if you just let these medical providers send “FINAL NOTICE” invoices after invoices and you finally pay? They give you a discount. That’s right, by waiting to the last possible second before being sent to collections, they’ll give you a discount because they are happy to recover any amount of money at that point (use this tactic at your own risk). All I can tell you is I would rather just pay everything up front and not have to deal with all this, but I’m now just a cog in a very broken machine. I already have 2 full time jobs being a dad and a computer geek, I don’t have time to be an health insurance reconciliation specialist.

End rant.