Rant: Soo, I had to call my health Ins. Company

Rant: Soo, I had to call my health Ins. Company (Full Version)

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maybemaybenot -> Rant: Soo, I had to call my health Ins. Company (10/13/2008 9:44:12 PM)
The company I work for merged with another company this year and with that merge came a new Health Insurance provider. I got the bill for two procedures today and was gobsmacked at how much I owed. I was sure there was a mistake. So I called the customer service number to question my bill. I was very nicely told that the CT Scan I had for a mass on my kidneys was determined to be non medical since the results showed a benign tumor, therefore was my responsiblity to pay. I also had two moles on my leg that were changing rapidly in color and shape and went to a dermatologist who biopsied and removed them. Again, Thank God, the results were benign. Again: I get to pay the entire thing because it was a " non medical" procedure. They have the gall to call that cosmetic. So now I am pissed off. I have never heard of insurance, where if the MD determines you have a medical condition that needs treatment/investigation, that the results of the test determine who pays what. Of course after I pay 2500 dollars out of my pocket they will pay 80% after that. yeeee fucking haw. Anyhooo. That's not what has me seeing red. During the course of the Customer Service person explaining my " benefits" as she called them, I said, I have had some lousy insurance in my day, but this is just obscene. I told her I knew it was not her fault, but that I was sickened by this shoddy coverage. You know what this bitch told me? I can't repeat it all, but it goes something like this..... Well, Ms. R, there is something you can do about it. The entire Health Industry needs reform and what you need to do is vote for Barack Obama. She then got on her soap box and lectured me on what Mr. Obama will do for me and how my health insurance woes will be resolved when he is elected. So does that mean the bill goes to Obama if/when he wins ? First let me say, I am a Libertarian and have no love for B. Obama or J. McCain. I will not be voting for either. So my outrage has nothing to do with which candidate " Wendy" wants me to vote for. " Wendy" needs to keep her mouth shut. Her job is a customer service rep, not a political worker. I pay good money for lousy health insurance and in the bargain I get little Miss Let Me Tell You How to Vote. My money helps pay her salary and I do not appreciate her political spewing. " I " pay her to explain health insurance, not advise the masses on how to vote. I have not made my mind up, but at the moment I am soo pissed I am seriously considering calling her supervisor tomorrow and reporting her. end of rant.....

rexrgisformidoni -> RE: Rant: Soo, I had to call my health Ins. Company (10/13/2008 9:47:26 PM)
You should have punched her in the face via telephone. And Vote For Genghis in 2008

BitaTruble -> RE: Rant: Soo, I had to call my health Ins. Company (10/13/2008 10:09:52 PM)
Oh no.. no no no no no. Don't seriously consider doing it.. actually do it! Health Insurance calls are recorded. She'll be busted. That shit just don't fly. I gotta say though.. you just inspired an idea in me. Next time I get a call from a telemarketer, I'm going to ask them who they vote for .. and no matter who they say, I'll respond 'wrong answer!' and hang up. Thanks!

meatcleaver -> RE: Rant: Soo, I had to call my health Ins. Company (10/13/2008 10:36:06 PM)
If someone needs to explain healthcare insurance to you, you aren't responsible enough to buy it because there is only one answer as to what health insurance is, it's a racket! My brother recognized that the first time he wanted insurance for his family on moving to the States. He also noted the medical professionals were in the racket too, when he went for an annual check up, he said, they'll have you going through all sorts of unnecessary procedures as long as you are healthy and can pay but if you need necessary procedures, the insurance company will make you pay for them because of some illegible clause in the contract. He feels the whole medical industry is stitched up between the insurance companies and the medical providers and both are mugging their customers.

proudsub -> RE: Rant: Soo, I had to call my health Ins. Company (10/13/2008 11:05:16 PM)
The exact same thing just happened to my daughter. She had a melanoma a few years ago and since then her doc has had all of her other moles mapped and several removed. She just got a bill from her HMO which isn't covering some of the surgeries because they claimed they were cosmetic surgeries. I think it's an outrage and she is fighting it.[:o]

NuevaVida -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 12:27:41 AM)
Last year the docs told me, "Remember that biopsy we did last year which concluded the tumor in your breast was benign? Well, yeah...um...we think we misdiagnosed it and you need surgery right away." OK so I had surgery right away. It was still benign, thankfully. My bill was crazy-high. C R A Z Y high. For a PPO, none-the-less. The tumor was benign, so they didn't cover the whole surgery. Um...'scuse me? I still haven't paid their damn bill. A smidgeon of it at a time, when I get around to it. Her comments on who to vote for were way over the top. I'm really glad the results were benign.

KatyLied -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 2:09:56 AM)
Wow, that sucks as does the political spew, completely inappropriate, in my opinion. I'm sorry to hear that you are going through this, especially the mass on your kidneys. Also, it's football season and I miss you....

pahunkboy -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 5:55:38 AM)
If that were me, I simply would not pay it. I dont think the clerk could get in trouble....[state insurance commission] tho it was unprofessional. You could drop a note to management over that worker. Any job I had - we were not allowed to "proselytize" meaning religion or political. Doing so was against the code of conduct and discipline would result. If you dont pay it it goes to collection agency. That might be a blotch for a new credit line. But really, who is issuing new credit? IF you insist on paying it- then ask for a reduced amount. I knocked 5% off this way...5% is 5%.

bluepanda -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 6:05:40 AM)
Hey! Where are all the "I Luv Merika" types in this thread, trumpeting about how we have the best health care system in the world? We need them in here ASAP to explain to us why we have it all wrong, and should be grateful for the horsefucking the health care cartel is kind enough to bestow on us.

kittinSol -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 6:13:24 AM)
Healthcare is better elsewhere (notably, cough cough, in France, and the UK, where it is completely free for everyone - that's what taxes should be for, people!). To argue otherwise is either ignorant or pigheaded.

pixidustpet -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 6:54:46 AM)
TheEngineer called around about the MRI he had to get last year. it cost $2500 to the insurance company, of which he had to pay 20% i believe. however, if he paid cash up front, he paid $800 and got all of the money back. my dr gives me a discount because i dont have insurance. office visit runs me about $130 including my tests (cholesterol, blood sugar, and a few other things). gads. kitten

bluepanda -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 7:01:02 AM)
quote: ORIGINAL: kittinSol Healthcare is better elsewhere (notably, cough cough, in France, and the UK, where it is completely free for everyone - that's what taxes should be for, people!). To argue otherwise is either ignorant or pigheaded. Yeah, but most of the people who are too stupid to get that are unable to grasp the concept of a world that extends beyond American borders. France might as well be in the Andromeda Galaxy, as much as they comprehend it. European countries are no more real to them than Middle Earth.

NuevaVida -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 7:05:52 AM)
A little rough around the edges there, eh panda?

bluepanda -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 7:21:16 AM)
quote: ORIGINAL: NuevaVida A little rough around the edges there, eh panda? Yeah, probably. It's a hot button for me. Aside from my own health issues over the years, right now I'm watching a very dear friend die of brain cancer. It's probable that she wouldn't survive no matter what, but the way in which she's dying would be much less stressful, much more peaceful, and much more dignified if we had a more civilized health care system. The people I'm talking about are the people who are directly responsible for our health care system being what it is, because it is their ignorance, short-sightedness, and self-centeredness that makes it possible for the health care cartel to perpetrate this corrupt system. If it sounds personal, well... that's because it is. To me, politics is very personal sometimes.

apiercedkitty -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 7:21:49 AM)
quote: ORIGINAL: pixidustpet my dr gives me a discount because i dont have insurance. office visit runs me about $130 including my tests (cholesterol, blood sugar, and a few other things). gads. kitten When i was without insurance, a doc i went to did that - but told me not to let it get around as it's considered insurance fraud. Now THAT'S something i don't understand - the insurance company only pays the doc what she charged me - why should someone with no insurance have to pay more? It's all a huge scam as far as i can figure.

KatyLied -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 7:26:31 AM)
quote: my dr gives me a discount because i dont have insurance. I wonder who is making up the difference. Is it my copay that my insurance is charging me? Just a thought.

pahunkboy -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 7:42:51 AM)
it floors me when i had a nerve test done on my arm, she said i would have to pay if the ins did not. i asked what the bill would be. she was clueless! so- when i seen she actually did not know- i humored her. said ok. [i needed the test to do the surgery] as it turned out the ins DID cover it.

NuevaVida -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 7:43:59 AM)
quote: ORIGINAL: bluepanda If it sounds personal, well... that's because it is. To me, politics is very personal sometimes. OK, well calling those of us who might not think like you "stupid" is making it a bit too personal, I think. Ironically, one of my favorite men in life (my uncle) was given an extra 3-4 years of life because he went outside the socialized medicine plan in his country and sold his business and home so he could pay for private care. The socialized system decided that since he wasn't going to make it anyway and his procedure would be too expensive to treat (esophageal and stomach cancer), surgery would not be in his future. To this day I'm glad for his decision, as it allowed us more time with him, and if you knew him, you'd agree with what a gift his life was to the rest of us. I didn't realize we were turning this thread into a political theme, but I'll just add that while I'm not opposed to socialized medicine, I'm not convinced that the people who fucked up our social security, our education system, our financial strength, our tax system....(get the idea?) should be in charge of my health. I respect your differing opinion and the pain you may be going through, but to lash out and label the rest of us as "stupid" is just rude and not doing much to convince your opposers of why you're right. Just sayin... (edited to remove an extra word)

MAMandSlave -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 8:03:08 AM)
quote: ORIGINAL: maybemaybenot The company I work for merged with another company this year and with that merge came a new Health Insurance provider. I got the bill for two procedures today and was gobsmacked at how much I owed. I was sure there was a mistake. So I called the customer service number to question my bill. I was very nicely told that the CT Scan I had for a mass on my kidneys was determined to be non medical since the results showed a benign tumor, therefore was my responsiblity to pay. I also had two moles on my leg that were changing rapidly in color and shape and went to a dermatologist who biopsied and removed them. Again, Thank God, the results were benign. Again: I get to pay the entire thing because it was a " non medical" procedure. They have the gall to call that cosmetic. So now I am pissed off. I have never heard of insurance, where if the MD determines you have a medical condition that needs treatment/investigation, that the results of the test determine who pays what. Of course after I pay 2500 dollars out of my pocket they will pay 80% after that. yeeee fucking haw. end of rant..... I am glad to hear that your results were begining. That being said, I dont know if the 2500 was your copay, but as long as your MD ordered the procedure and deemed it non cosmetic, or of medical necessity. If you go to your md who ordered the test and verify that it was ordered as a medical procedure, not cosmetic, then contact the claims department and request to dipute the decision, they will send you the paperwork to appeal thier decision. the time for the insurance company to deny the claim was when the md requested the work, not afterwards. This is grounds for appeal. All things like mri's have to be pre approved, so it probably was. I suggest you appeal. It will save you a bunch of money. (I used to work customer service at an insurance company) Good luck to you. Sorry you were lectured, the others are right, it will result in an immediate fireing if you report it, and it was recorded.

bluepanda -> RE: Rant: Soo, I had to call my health Ins. Company (10/14/2008 8:06:54 AM)
quote: ORIGINAL: NuevaVida quote: ORIGINAL: bluepanda If it sounds personal, well... that's because it is. To me, politics is very personal sometimes. OK, well calling those of us who might not think like you "stupid" is making it a bit too personal, I think. Ironically, one of my favorite men in life (my uncle) was given an extra 3-4 years of life because he went outside the socialized medicine plan in his country and sold his business and home so he could pay for private care. The socialized system decided that since he wasn't going to make it anyway and his procedure would be too expensive to treat (esophageal and stomach cancer), surgery would not be in his future. To this day I'm glad for his decision, as it allowed us more time with him, and if you knew him, you'd agree with what a gift his life was to the rest of us. I didn't realize we were turning this thread into a political theme, but I'll just add that while I'm not opposed to socialized medicine, I'm not convinced that the people who fucked up our social security, our education system, our financial strength, our tax system....(get the idea?) should be in charge of my health. I respect your differing opinion and the pain you may be going through, but to lash out and label the rest of us as "stupid" is just rude and not doing much to convince your opposers of why you're right. Just sayin... It's a very good point, but I want to make clear that I'm not saying that everyone who thinks differently than I do is stupid. I'm not even saying that everyone who opposes a national health care system is wrong, much less stupid. What I said was that most people who are unable to grasp that some other countries, and some other health care systems, offer better overall health care than the American model are ignorant. And not even all of them. I've heard a few fairly well-assembled arguments against that point, but not many, and not very compelling, because the numbers pretty much speak for themselves. However, I at least give those people credit for understanding what they're talking about, for arguing from a position of belief rather than a position of blind faith, and for trying to make their case. I respect them, and their arguments, even if I don't agree with either. If they at least understand the facts of the issue, and are still against a national health care system, then fine. I disagree with them, but I respect their point of view. It's the people who don't know shit about the issue, and have no interest in learning anything about it, that poison the process. Most people I've heard arguing from the other side of this issue don't have anything to back up their position. They just parrot whatever they heard Rush Limbaugh say, and when you try to close in on the core of their argument by asking them to explain what they mean, they just repeat the sound bite over and over again as if it's self-explanatory. Those people, I don't respect. And it's those people to whom I refer. And sadly, in my experience, they represent the majority of the people on the other side of this debate. And I'm very sorry about your uncle. I lost someone close a few months ago too. I hope you and your family are doing as well with that as is possible.

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