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[IP] Re: insurance questions on "supplemental supplies"
> If all else fail write a complaint letter and demand an answer to your
> questions (find out who you need to send it to/what dept).
I am beginning to learn how to deal with insurance companies. I have
bc/bs hmo nevada. I have recently had a problem with them for pump
supplies that I got last year and a laser eye doc appointment in
February. The first clerk that I spoke with gave me a list of
procedures that I had to follow, which 'may' get the approval. I really
didn't want to spend hours trying to prove that I was right (I was). I
asked for the next in line to speak with as I was going to work my way
up. I was told that the super would say the same thing as there was
nothng that could be done and it was the things were. I asked if she
would please give me a number for the Nevada Insurance Commision and was
told that she would 'gladly' get it. I did not threaten, just that I
needed the number for the next step. In about 2 minutes I had a
supervisor on the phone, who was absolutely apologetic and listened to
my point of reasoning. She spent another 2 minutes investigating and
found that my appointment for Dr Parker was approved (it was to Dr Simon
who is a partner and just listed first in the phone book) and that she
would have the original clerk do all of the phoning to take care of the
pump supplies, including ones that I now have on order.
I don't know if it's everywhere (YMMV) but I got the distinct impression
that management at these insurance companies do not want to hear any
inquiries from insurance commisions. I don't think that going to
insurance commisions will fix all insurance problems, but it can't
hurt. The front line is probably told to be rather strict on their
responses, and it will do no good to plead with them, while the
management needs to stop any problems before they progress (part of my
job description). I personally believe that insurance companies, and
hmo's, are walking on eggshells right now (anybody watch the democratic
convention?) and that should be taken advantage of. We all have buttons
that can be pushed.
email @ redacted
A conclusion is simply the place where someone got tired of thinking.
- Arthur Block.
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