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Medical Forum / Diseases and Disorders / Arthritis / March 2005OT - Insurance Rant
<ranting mode on> ...I guess the Big Guy has decided that I need to have insurance problems, again. Oh well, I am, I think, rather used to dealing with them, so... This new one is UHC is saying that Medicare should be billed first, and then them. Medicare says, uh, no *we* are never primary, unless there is no other insurance, only supplemental. Great. Called UHC and spoke to Ricky. Said that Medicare is secondary insurance, and UHC is primary. He said, yes, that's what is in your file. I asked, why then are you not paying the bill for my bloodwork? He said, we need to see what Medicare is covering first. Okay, wait a minute. UHC is primary, the first insurance billed? Yes, he says. Then why are you waiting to see what Medicare will cover? I don't know. You are very nice Ricky, may I please speak with your supervisor? Same discussion ensues with the supervisor. Then, lo and behold, the supervisor says, "Oh, I see here where Medicare is listed as your SECONDARY insurance." Um, HELLO? Haven't I been saying this exact same thing for the last 45 f***ing minutes? Oh, I'm sorry, I didn't mean to swear. I'm tired and I'm sick, and this isn't what I was expecting to deal with first thing this morning (07:00 am Mountain Standard Time). End of story, they are resubmitting my claim (by the way, this is the 4th time I've asked them to relook at this claim). I ask, is there anyway to put a flag on the account that Medicare is secondary? Oh, no, Mrs. Brown, we can't do that. So, I get to go through this every single time? I'm sorry, but yes, you do. Great, have a nice day won't you? Grouse, grouse, grouse... <ranting mode off> Thank you ever so, for allowing me this moment (or however long it takes to read this) to get that out of my system. Smokie Darling (Annie) - no responses required, I realize I am not the only one to have insurance problems. I should be grateful (I am, really) that I have any insurance at all. Just wasn't prepared for that. I'm sorry but I had to laugh when I read your rant. I had UHC when I worked and under Cobra and went through much the same stuff as you did. I truly believe they either hire people who don't listen or read or else they train them to do that. Do you suppose a lot of folks give up and pay the bills themselves? Ann -I have to wonder sometimes if they search college campus for all the people who have low IQ scores and decide to give them jobs as claims adjusters??? Just wondering here. I am sorry that you had to deal with a dipsh*^ this AM thats not good. > <ranting mode on> > [quoted text clipped - 40 lines] > really) that I have any insurance at all. Just wasn't prepared for > that. We have these same nuts as secondary insurance. They are suppose to pay a percent for acupuncture. I have submitted the forms. They don't know Marty. What do you need I ask. His name, id number, location,... I say it is on the form. We don't know him they say. What do you need I say. So for two years this is the game. I finally gave up. Guess they won. What the hell are we paying them for... Oh sorry. ranting feels nice. Duckie > <ranting mode on> > [quoted text clipped - 40 lines] > really) that I have any insurance at all. Just wasn't prepared for > that.  Signature_('> (_<_) _ _('< -quack (_<_) _ __('< *QUACK!* <_{__) _('< "|,,|_" (_<_) _('< "AFLAC!" (_<_) Yikes, Annie, no wonder you are so frustrated!!! I'd be a tad frustrated too! BTW, I also have medicare as secondary and for some reason, that really confuses billing departments and insurance companies. I have been pretty lucky though as my primary insurance company has finally gotten it and now do what they are supposed to do for the most part. Oh, and BTW, they CAN flag your account to show that they are primary. Sounds like little miss supervisor was just too lazy to do so. Think I would have asked to speak to her supervisor next! Sure hope it gets worked out and that you don't have to keep phoning them and going through the same nonsense. Hang in there my friend!!! Donna G > Smokie Darling (Annie) - no responses required, I realize I am not the > only one to have insurance problems. I should be grateful (I am, > really) that I have any insurance at all. Just wasn't prepared for > that. heehee, you remind me - my dad went through "phased retirement", a trick they have for faculty in Florida and maybe elsewhere. It meant that for 5 years he taught one semester on payroll and the rest of the school year he was on retirement but still had office and research rights in the department. The semester that he worked, the state BCBS plan was his primary. The other 8 months of the year, Medicare was the primary. Talk about headaches! Actually, the insurance companies handles it fairly well, but the hospital could never get it straight no matter how many times Mother told them who to bill first. Daddy was having a lot of joint surgeries around then and Mother got so sick of dealing with various billing departments who couldn't get it right! SignatureNann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare I also have Medicare as secondary and it really confuses the people who do the claims in the doctors offices. They are so used to the rules when Medicare is primary and they just can't understand that the rules are different when it is secondary. I always get an arguement when I try to explain to them that Medicare will pick up my primary deductable and co-pay. Oh they want to argue that one! Usually they agree to file it and try when I suggest that "OK, I'll go ahead and pay you (my co-pay/deductable) and then you can owe me. Maybe it's easier for you to give me a refund than it is for me to owe you if I'm wrong." After thinking it over, they usually decide that processing a refund is more of a pain in the butt and let it go. The other place I get an arguement is in places that don't file secondary insurance as a policy. Medicare requires that the provider file it themselves especially if they accept Medicare Assignment. It's a rule of theirs. SignatureCyberhugs, DianeW It is only with the heart that one can see rightly; what is essential is invisible to the eye. --Antoine de Saint Exup?ry <ranting mode on> ...I guess the Big Guy has decided that I need to have insurance problems, again. Oh well, I am, I think, rather used to dealing with them, so... This new one is UHC is saying that Medicare should be billed first, and then them. Medicare says, uh, no *we* are never primary, unless there is no other insurance, only supplemental. Great. Called UHC and spoke to Ricky. Said that Medicare is secondary insurance, and UHC is primary. He said, yes, that's what is in your file. I asked, why then are you not paying the bill for my bloodwork? He said, we need to see what Medicare is covering first. Okay, wait a minute. UHC is primary, the first insurance billed? Yes, he says. Then why are you waiting to see what Medicare will cover? I don't know. You are very nice Ricky, may I please speak with your supervisor? Same discussion ensues with the supervisor. Then, lo and behold, the supervisor says, "Oh, I see here where Medicare is listed as your SECONDARY insurance." Um, HELLO? Haven't I been saying this exact same thing for the last 45 f***ing minutes? Oh, I'm sorry, I didn't mean to swear. I'm tired and I'm sick, and this isn't what I was expecting to deal with first thing this morning (07:00 am Mountain Standard Time). End of story, they are resubmitting my claim (by the way, this is the 4th time I've asked them to relook at this claim). I ask, is there anyway to put a flag on the account that Medicare is secondary? Oh, no, Mrs. Brown, we can't do that. So, I get to go through this every single time? I'm sorry, but yes, you do. Great, have a nice day won't you? Grouse, grouse, grouse... <ranting mode off> Thank you ever so, for allowing me this moment (or however long it takes to read this) to get that out of my system. Smokie Darling (Annie) - no responses required, I realize I am not the only one to have insurance problems. I should be grateful (I am, really) that I have any insurance at all. Just wasn't prepared for that. Hi Annie,,, I run into that all the time. All the hospitals,,, clinics,,, hit Medicare first. Besides out right thievery which on going,, it is the reason for the cost of Medicare being so high. I had a friend that got after a company that was double billing Medicare and they were trying to do him the same way. He took it too as high as he could go with the company and told that person that he could prove what he was complaining about and they completely dropped all billing if he would not push this any further and it was worth about $12,000 just to him. We need to check our bills because the gov. is not. Harv > <ranting mode on> > [quoted text clipped - 40 lines] > really) that I have any insurance at all. Just wasn't prepared for > that. It must be National Fight with Insurance Companies Day! I woke up this morning and logged onto my online banking to check that my disability check had been direct deposited. When I looked at the amount, I couldn't believe my eyes. It was over $200 less than it should have been. So I called. Turns out that the medical leave administration at my employer cut off my disability without letting me know. Evidently someone decided that I should have been able to go back to work on March 8th, so they cut everything off on the 7th (without telling me!). They had sent me additional papers the other day which I took to the cardiologist yesterday and he filled them out and faxed them back for me. He's very good about doing that kind of stuff. Now they tell me that my case is being reviewed by their medical board and they can't tell me anything for 3-5 business days! The cardiologist says I'm supposed to avoid stress, which is why he told me that when the disability people called me I should tell them to call him directly. I'm doing everything he is telling me to do. I got so annoyed this morning on the phone with the disability people. I finally got put through to a supervisor. Of course all I got was voicemail and she still hasn't called me back, so I'm sure it will be Monday before I hear back from her. So much for no stress. Ugh! So I can definitely empathize with you, Annie! BTW, I also have UHC, and I've found that if I get a twit on the phone, I call back later and speak to someone else. I have found that I get better service at about 5pm pacific time :) Hang in there, everyone keeps telling me that things are going to get better! Carole :) |
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