OT: Hissy fit - Page 5

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Subject Author Date
OT: Hissy fit F.James Cripwell 11-07-2009
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Posted by Susan Hartman on November 10, 2009, 8:01 pm


Lucille wrote:
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We had BC/BS of Maryland for many years, and they were difficult to deal
with. Several hissy fits and many, many hours on the phone.

The past two years we've had BC/BS of West Virginia, and I can't believe
the difference!! They're courteous, efficient, and a delight to talk to.
And I don't think I've ever had to call more than once for the same problem.

So don't judge them all by the measure of one. I wouldn't have believed
it myself.

Sue

--
Susan Hartman/Dirty Linen
The Magazine of Folk and World Music
www.dirtylinen.com

Posted by Lucille on November 10, 2009, 9:15 pm



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I'm glad someone has something good to say about them. I'm on Medicare and
when I was looking for a supplement, here in FL I found BC/BS to be one of
most expensive and giving the least of all.

Lucille


Posted by Cheryl Isaak on November 11, 2009, 7:31 am


On 11/10/09 8:01 PM, in article
H1oKm.156211$uO.8473@en-nntp-09.dc1.easynews.com, "Susan Hartman"

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I know in Ma and NH, there were many civil suits against BC/BS over denial
of coverage, especially for "female issues" in the mid to late 80s. And
there was some serious pee-pee slapping over it including fines and making
them repay clients who paid their hospital bills.

When we had them again later in the late 90's (96-97), they were still
painful but not like they had been. And still bad on issues regards women's
health...


Cheryl


Posted by ellice on November 10, 2009, 12:07 pm



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*snip*
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Great story. When I had the little uterine problem, plus they were removing
part of an ovary, I was in the hospital for supposedly 4 days. Which turned
into 6 or 7 days because the surgery was more severe, and they couldn't do a
"bikini line" incision so required longer stay, etc. Anyhow, my doctor
comes in on day 2 and says, hmmmm, your insurance company is now denying
claim. So, I call them - from the bed - because the hospital admin claims
person has come up. I'm on meds, argue with hospital person, essentially
similar to you Cheryl, and then call insurance company. Get to supervisor,
trying logic, and finally, oh, we're sorry, and of course all is covered.
Um, no, this wasn't a laporoscopy outpatient hing, but had been
pre-certified for in hospital, with some contingencies depending on tumor
sizes, etc. Now on day 4 - when I'm barely walking - hospital admin comes
in and tells me that she has decided I could go home, because they have to
daily contact insurance to be sure that all is covered for everyday after 3,
and well, lucky me, they covered today, but you should go home today. Of
course, several things have to be a go before you can be released, and I ask
her if she's a doctor. Of course now my doctor comes in, and is blowing a
gasket at the admin, to whom I just essentially tell - you're not a doctor,
or medical professional, you have no medical education to be making a
patient assessment, and I'll take care of this. Call the insurance company,
they call doctor's office - all is fine - they just needed the confirmation
from the doctor that I would require 6 days, and let them know if it'll be
over a week. It was the hospital administrator being an ass - 'cause the
insurance rate of course is a lesser reimbursement than some of the other
carriers.

It's so important to be your own advocate, but I've learned to resist the
yelling - however DH says that I have a certain very cold, emphatic, scarey
tone of voice which works quite well for the "inner bitch" kind of thing.
Works great on the ice with the "go to the box, NOW" kind of comment.

Ellice


Posted by Cheryl Isaak on November 10, 2009, 1:34 pm


On 11/10/09 12:07 PM, in article C71F07E9.18379%egirl22@verizon.net,

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I generally don't yell at people on the phone unless it's another one of
those borderline scammers.


BUT - I'd about had it - they were doing everything possible to deny this
claim. I wasn't having anything removed or even in overnight. It was drain
the beast before it burst and possibly caused worse problems - like
infection, internal bleeding. And lets not even mention the pain it was
causing and the potential issues if I was walking from place to place at
home. (the guys I worked with drove me home - I was out of work for 12 days
from the second day of the start of the pain.)

Cheryl


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