JimBowie1958
Old Fogey
- Sep 25, 2011
- 63,590
- 16,753
- 2,220
OK, I have a family plan with a health insurance company whose name I dont want to give out, but lets just call it for the time being, ETNA.
Before I went on vacation to Canada, I called and asked about filing my Gap insurance coverage for a Dr Boatang (not actual doctors name). In the course of my several discussion with several different ETNA call handlers, it finally emerged that, to my surprise Dr Boatang was in their system. So I was told to wait till I got back from vacation and just submit the bill. So that was the plan.
I get home and cant find my $3k bill, so I call the doctors office and ask them to email me my bill, and they do. I then take my bill and upload it to ETNA on their website.
A couple of weeks go by and I get a call from Dr Boatangs office that informed me that ETNA told them that I was not in the ETNA system. I call ETNA and after about 2 hours of talking with one person then the next I was, of course, in their system, but the real problem was that my bill, uploaded to the website, did not move the bill to their billing side of their operations. So the lady kindly took my bill, printed it out and then uploaded it again to the billing side of their operations. I ask to talk to a supervisor to complain about how broken their billing system is, and I am told that they dont have a complaint handling manager, but they could escalate my call to a high priority call desk, and I ask them what good that would do to fix their broken part of their billing system. "Nothing" I was told, so I declined.
Then last week I got this response letter from ETNA saying that they declined to cover my treatment since my doctor was not in their system. Yes, the same doctor that they had told me only a few weeks ago that he was in their system. So I look up this doctors information, see that he take ETNA and I just called ETNA to find out what the hell is going on. Ow, wow, the problem was that the bill, after being loaded up and scanned a second time the name and PID was illegible. So why didnt they say that the doctors name was illegible instead of not in their system? The didnt know. Well I could give them the PID over the phone and any other information that they need. No, that wont do it has to be part of the bill.
But of course I cannot submit a second bill for the same closed claim, so they tell to send a message to the message center and they can get the clean copy of the bill that way. I ask to speak to a manager or someone that I can get to shepherd this bill through to the proper people in their broken bill system. Again I am told that they dont have anyone that does this.
So now that Trump has won, are the insurance companies returning to their old bullshit games to deny people due coverage?
It would seem so, as I have also recently experienced the same kind of thing with a State Farm Claim for medical coverage and with a disability insurance claim that took me off disability even though my medical condition was made much worse than when they first put me on it.
This is NOT how one makes American great again, folks.
Before I went on vacation to Canada, I called and asked about filing my Gap insurance coverage for a Dr Boatang (not actual doctors name). In the course of my several discussion with several different ETNA call handlers, it finally emerged that, to my surprise Dr Boatang was in their system. So I was told to wait till I got back from vacation and just submit the bill. So that was the plan.
I get home and cant find my $3k bill, so I call the doctors office and ask them to email me my bill, and they do. I then take my bill and upload it to ETNA on their website.
A couple of weeks go by and I get a call from Dr Boatangs office that informed me that ETNA told them that I was not in the ETNA system. I call ETNA and after about 2 hours of talking with one person then the next I was, of course, in their system, but the real problem was that my bill, uploaded to the website, did not move the bill to their billing side of their operations. So the lady kindly took my bill, printed it out and then uploaded it again to the billing side of their operations. I ask to talk to a supervisor to complain about how broken their billing system is, and I am told that they dont have a complaint handling manager, but they could escalate my call to a high priority call desk, and I ask them what good that would do to fix their broken part of their billing system. "Nothing" I was told, so I declined.
Then last week I got this response letter from ETNA saying that they declined to cover my treatment since my doctor was not in their system. Yes, the same doctor that they had told me only a few weeks ago that he was in their system. So I look up this doctors information, see that he take ETNA and I just called ETNA to find out what the hell is going on. Ow, wow, the problem was that the bill, after being loaded up and scanned a second time the name and PID was illegible. So why didnt they say that the doctors name was illegible instead of not in their system? The didnt know. Well I could give them the PID over the phone and any other information that they need. No, that wont do it has to be part of the bill.
But of course I cannot submit a second bill for the same closed claim, so they tell to send a message to the message center and they can get the clean copy of the bill that way. I ask to speak to a manager or someone that I can get to shepherd this bill through to the proper people in their broken bill system. Again I am told that they dont have anyone that does this.
So now that Trump has won, are the insurance companies returning to their old bullshit games to deny people due coverage?
It would seem so, as I have also recently experienced the same kind of thing with a State Farm Claim for medical coverage and with a disability insurance claim that took me off disability even though my medical condition was made much worse than when they first put me on it.
This is NOT how one makes American great again, folks.
