insurance rant

[Lynlw]

I posted this on my CHD group, but thought some of you might se the 'humor' in this
Ok, Since Justin is 19 and has had 4 OHS, pacemaker surgeries and assorted
broken bones, I have dealt with alot of stupid annoying Insurance things, but
todays takes the cake. I got a letter from BSBC thrid party collection from
Justin's heart surgery 2 yes 2 years ago. They explained that they are not
responsible for claims caused by dog bites, airplane ,bus accidents and a few
other things like that, so please call to find out who they can bill for the
third party claim. so I called and said my son's heart surgery was not caused
because he fell, was in an airplane crash or a dog bit him. She said well it
does say heart and sometimes they a re because of accidents. I "nicely" pointed
out, that instead of wasting all this time and money and aggrevating me, did
they bother to see this was his 4th OHS and they have been paying them since he
was 10 days old and no he wasn't bit or work related then. And while I have you
on the phone please note that he will be having another surgery in
2 weeks and NO that will also not be related to any of the above issues you are
not responsible for.... huge sigh, well thanks for the vent, I feel alittle
beetter now. oh and interestingly they were only disputing the first 2 days
apparently the rest of the week was not a problem...idiots, Lyn
www.caringbridge.org/nj/justinw

 

[ToFMom]

Unbelieveable!!!

Unbelieveable!!!

Can't believe they would think the heart was related to an accident.,etc., especially with his history of claims!! This insurance stuff is NO fun. I just started getting the billings for my son's surgery on May 4th. So far we are at about $95,000. Healthpartners keeps sending these individual sheets for who they are paying, etc. The hospital bill came and wasn't even a itemized billing; just categorized. Hopefully they provided Healthpartners with more info! We have an odd situation in that my son is only covered under my insurance until the end of May (as he graduated college on 5/12) and is covered for this month. If he has appointments for June, we will have to elect the Cobra coverage. His new insurance with his new job starts on July 11th. So it is a game of arranging appointments before end of May if we can. I hear you on the venting thing...glad to hear I'm not alone!!!

 

[Nancy]

Who makes up these regs, and who hires these people? I swear it is the dumbing down of America.

Some things are too stupid to believe.

And insurance companies are always trying to weasel out of everything.

They sound SO professional when they want your business and SO unprofessional when they have to pay.

So I guess all the brilliant people are in insurance sales, and the stupid ones are in bills payable and accounting.

 

[Lynlw]

Who makes up these regs, and who hires these people? I swear it is the dumbing down of America.

Some things are too stupid to believe.

And insurance companies are always trying to weasel out of everything.

They sound SO professional when they want your business and SO unprofessional when they have to pay.

So I guess all the brilliant people are in insurance sales, and the stupid ones are in bills payable and accounting.

I agree with everything you say. and I've been wonderring since all of a sudden they are disputing the claim from 2 years ago, if it is just a coincidence he is having surgery in 2 weeks, and maybe they hope if they can dispute the last surgery , they can get out of paying for this one.
Justin decided a couple weeks ago, after watching me make all these calls, appt dealing with this, that his new "master plan" is to freeze me right before i die so he can thaw me out to deal with this stuff when he is 94. When we got this letter he said this is my master plan is so good, you are really good at this stuff, Gotta love him, lyn

 

[Mary]

Lyn,
I had this happen after my replacement. I was leaving one insurance policy and going to another. First insurance group was paying for the surgery, but the second group would be picking up all subsequent bills. Although they were both BC/BS they were two different plans. If I remember correctly, there was some discussion because I was eligible for short term disability. So the question I received asking whether it was due to an injury, actually came from a third insurance party who works for both! They read "disability" as "possible workmen's comp".
The whole situation disappeared as soon as I answered the question, "is this related to an accident?"
They're not trying to drive you crazy, just trying to save themselves money!
So what else is new!

 

[Ross]

Don't even get me started on this subject.

 

[Lynlw]

Lyn,
I had this happen after my replacement. I was leaving one insurance policy and going to another. First insurance group was paying for the surgery, but the second group would be picking up all subsequent bills. Although they were both BC/BS they were two different plans. If I remember correctly, there was some discussion because I was eligible for short term disability. So the question I received asking whether it was due to an injury, actually came from a third insurance party who works for both! They read "disability" as "possible workmen's comp".
The whole situation disappeared as soon as I answered the question, "is this related to an accident?"
They're not trying to drive you crazy, just trying to save themselves money!
So what else is new!

I could kind of see that, if we changed insurance, applied for short term disability or even was his first heart surgery that they've had to pay for. I'm not even sure IF there was a 3rd party claim, if they would be able to collect if they waited 2 years to try to get reimbursed

 

[Ross]

I could kind of see that, if we changed insurance, applied for short term disability or even was his first heart surgery that they've had to pay for. I'm not even sure IF there was a 3rd party claim, if they would be able to collect if they waited 2 years to try to get reimbursed

It depends on the state. In Ohio, statue of limitations is 5 years unless it was under a written agreement, then I think it's 10.

 

[Guest]

They sound SO professional when they want your business and SO unprofessional when they have to pay.

Oh my yes.

*sighs*

Like Ross, don't get me started on this subject.

Sssooo ... instead, I'll just type:

Lyn ... very sorry you had to deal with boneheads like that. I really wonder sometimes how companies actually DO business since they can't seem to keep their own stories and records straight.

*shakes head*



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