OK, so perhaps it’s just freaky coincidental timing (and a testament to Jon’s strongly worded letter), but a couple of hours after posting about our Blue Cross shenanigans, the phone rang, and Blue Cross showed up on the caller ID.
Admittedly, I panicked for a second before picking up the phone. It felt a tad big brother.
The Blue Cross representative and I discussed the claim. I told her that we thought it was absurd that we were paying $1000+ a month in out-of-pocket premiums, never go to the doctor other than well visits, don’t get prescriptions filled, etc., yet we were being denied flu shot coverage because the person who gave the shot was registered in another state. Even though we got the shot in the appropriate state.
She changed course and said that since we’re under a managed care plan, we would have been covered if we got flu shots from our PCPs. I told her that when I called our PCPs they told us they didn’t have any flu shots available for us and told us to go to a public flu clinic. (This absurdity is a whole other matter entirely.) We went back and forth for a few minutes. She said that next year we needed to go to our PCP to get covered, or to a limited care clinic such as CVS, which contracts with Blue Cross.
And then she told me she would make an exception and reimburse us for our flu shots.
Excuse me while I go pick my jaw up off the floor.
February 3rd, 2010 at 11:53 am
don’t you love how they act like they are doing you some kind of favor!? We also have blue cross blue shield ma and it’s a big possibility thatour 5 month old daughter will need surgery for her crossed eyes, i am not looking forward to even finding out if this is covered.
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February 3rd, 2010 at 12:53 pm
Take the money. But keep grumbling!
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February 3rd, 2010 at 1:37 pm
Ah, behold the power of Twitter. (Congrats!)
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February 3rd, 2010 at 2:33 pm
Did they give you a time frame of when to expect the check? I’ve had BC play games for months on a claim they promised to re-process because it was processed incorrectly the first time. Every time I called they said it was being handled and I should see the correction within 30 days. Well, it must have taken at least 4 months to fix. Just keep track of dates and who you spoke to and what you were promised. Luckily I had a very patient doctor who gave me the extra time needed to get the bill paid through Blue Cross, but since you’ve already paid out of pocket, you’re the one who gets screwed if they don’t come through with their promises. Although, you’re angry with insurance companies, don’t drop your coverage. It’s not worth taking the risk. You might want to threaten them that you will drop the coverage if they continue to play games, but don’t do it…unless of course, you can find a cheaper premium or better coverage elsewhere. Good luck…hope you see the money soon.
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February 3rd, 2010 at 8:49 pm
It obviously pays to make some noise. I just really wish it wasn’t necessary and that companies would behave ethically without threats. Pipe dreams?
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