Of all the convoluted messes. Why must they make insurance so incomprehensible? Instead of making it to where you can understand it they have to use special codes and abbreviations. Okay...I can understand the need for that, but the problem is no one ever sits down and explains how it works and what everything means so that when you have a claim you can easily decipher what is your responsibility and what isn't. Here's the other silly thing...They should make a standardized Explanation of Benefits so that it doesn't matter who you have your insurance with the forms, how you read them, etc are all the same.

My proposal on how to un-convolute this mess:
A. Educate the Insured
1. A required class perhaps.
a. Probably at the high school level where the government already maintains some say-so over the curriculum requirements. College level would make more sense, but would be harder to try to standardize. (Face it this is something everyone needs to understand at least a bit.)
2. Include:
a. vocabulary
b. understanding your policy (how to use that vocabulary in context)
c. reading/understanding your insurance card
d. reading/understanding your Explanation of Benefits (EoB)
e. examples
"John fell and injured his arm. He made a trip to the emergency room thinking that it might be broken. X-rays were taken by the radiology department...' '...John paid his co-pay of $150, the hospital charged John 'v' amount for services rendered, 'x' amount was discounted for using an in-network provider, Johns insurance pays 'y' amount. The remaining 'z' amount is John's responsibility.' and so on and so forth...
Such examples would, of course, need to include billing statements, EoB's, etc. to maximize understanding of various insurance components.
B. Emphasize Etiquette
1. How to be polite when confused/worried/upset/etc.
2. Remember to to shoot the messenger--receptionists, secretaries, billing/accounts' personnel--they don't make the rules they just have to pass them on.
C. Insurance companies standardize EoB layouts
-so that it doesn't matter if you Blue Cross Blue Shield, Cariten, or any other insurance company.

Okay, perhaps it's not a very well thought out (or too thought out considering this started as a rant!) and not very practical. But who said my rants had to be practical.

I guess this rant stems from recent frustrating events from both sides of the spectrum. I had a rather irate parent call me at work yesterday. Somehow it became my fault that the secondary insurance company said they hadn't met the deducible. (Hence the manners section...and the not killing the messenger statement.) And this afternoon Jared and I were looking at account statements (?) for what charges are being billed to our insurance for Jared's recent leg 'mishap.' I don't work with insurance claims daily, but i work with them more than many people do, yet I still have a hard time understanding them. I'm learning, but it is still very confusing. I can't blame that parent for being confused and upset (though I can for being rude to me when I can't do a thing about it--in her defense she did apologize though, which did a lot to improve my attitude).