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[IP] I think I may beat the insurance company!!!
Some of you may remember my months of woe when my work changed from MedBen
(who was paying for my pump supplies as prescription with those copays) to
Anthem BCBS (who wanted a $400 deductible and then 20% copays). I went on a
letter writing campaign from my HR Dept. all the way to the CEO of Anthem. I
was contesting the fact that tubing even is durable since you throw it away
every 2-3 days, and haranging them for not wanting to encourage better health
now instead of paying for more expensive complications later. Basically, my
letter writing campaign went no where. I think my HR dept. has now blacklisted
But the lady that informed my that my appeal was denied sent me a single
copied page out of my several hundred page benefit booklet that said "Note:
Physician office copayments are applied rather than the Network Copayment
listed above if medical supplies, Durable Medical Equipment, or applicances
are obtained in a Network Physician's office".
Of course, one customer service rep. at Anthem BCBS told me that this would
still be coded as DME and billed that way even when I read this paragraph to
her. Another said I was correct. I finally got the clinic where my doctor's
office is located to start calling. They have agreed to try to get this taken
care of before my schedule office visit with my endo next week. (Although if
it takes longer I will reschedule).
I may finally beat the insurance company!!!
After the months of writing letters, making calls, being left on hold for
hours, and being told something different every time I talked to a member
services rep, I may finally win! WOOOOHOOOOOO
When I win I will go dancing through the hallways doing a chicken dance.
(Of course, I will probably have to do this all over again at the start of the
new year, but that's later.)
>From the thriving metropolis of Bowling Green, KY
Who has angered so many member service reps. that they don't even want to tell
her their names anymore.
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