Steve Wacksman for Reader's DigestDear Sir/Madam/Dependent/Spouse/Dependent No. 2,
This notice is to inform you that the procedure/treatment performed on January 2, 2015, is not covered under your health plan by reason code L0L.
Receiving an Explanation of Benefits showing that a service was not covered can be confusing and frustrating. We are here to help. Please refer to the following reason codes explaining why your problem cannot be covered.
PRE&PRE: This service requires preauthorization of the preauthorization.
PENPAL78: The Plan will not pay for this service until you mail forms back and forth with us seven or eight times.
V0Cab: Because we’re not sure what the word maxillofacial means.
TOS5UP: If there is a conflict between what is written in the Benefit Handbook and your Health Contract, we will flip a coin. If we don’t like the outcome, we will flip again.
N1C3TRY: Procedures that involve the eyes, legs, nose, or throat are deemed to be investigational according to our criteria. What a mystery the human body can be!
N0D1CE: Even though you received services from a Participating Provider, he hasn’t been joining in of late. Also, we don’t like his new mustache.
5ONG: Because the song “Shake It Off” is stuck in our heads, and it’s driving us crazy.
DuMBA55: The Plan does not cover foreign objects in ears if the patient is an adult and the object is something stupid. Examples include a Cheerio, a Lego, a crayon, an hors d’oeuvre, a chess piece, and a gummy bear.
WhatTH3: Why, oh why, did you go to the doctor for this? Couldn’t you have had Spouse/Dependent/Dependent No. 2 just get you an ice pack?
MATH4U: The Participating Provider/Network Not Available benefit after copay is equal to, less than, or greater than the fee allowance/coinsurance/out-of-pocket limit, or ab2x4+bx3+cx2+dx+ad2=0.
OOPSx2: Not again! Really? Didn’t you learn your lesson the first time?
If you have questions about why we have not paid your claims, our staff is available to converse with you Monday through Tuesday, 8 a.m. to 8:30 a.m., in Code, pig Latin, or emojis. We look forward to serving you by avoiding your health-care needs! Isthay is otnay an illingbay!
Please retain for your records.
Serena Crawford is a fiction writer. Her story collection Here Among Strangers won the Spokane Prize for Short Fiction and is forthcoming in 2016.