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[IP] Well it only took 2 years

This one is a dilly..... if you need a laugh...
Background.... as you know, my daughter Lily has been a pumper for 
many years. In April of 1999, I purchased a box of One Touch strips 
at the Safeway Pharmacy out of town when we were away a a soccer 
tournament. Our insurance (Blue Shield of Calif.) at the time 
required that strips be purchased at the pharmacy and submitted for 
reimbursement as DME. So.... that receipt along with two other were 
submitted for reimbursement in the usual manner some time later. One 
of the receipts was blank except for item and $$, one had only the 
first name "Lily" and the Safeway receipt had my name on it with the 
last name mispelled Robinson instead of Robinton (more on this 
later). Betcha' can't guess.... heh... heh.... of course the claim 
for the Safeway item was processed in my name and applied to the 
deductible. Lily of course has already met her deductible limit. So, 
being the nit picker that I am, I called BS and explained that I'm 
the dad and "yes, the receipt is in my name" and "no I do not have 
diabetes, and "yes it really is for my daughter.  Well...... the 
response was "I'll send it to my review department and a new EOB will 
be issued". The end result of that process was, of course, a denial 
of the claim citing as reason that the "prescription" was in the name 
Michael Robinson and that it had been applied to my deductible..... 
gee, I knew that!!! After iterating this procedure a few times, I 
finally wrote a nasty letter pointing out the error of their logic 
and demanding that I be reimbursed for Lily's strips. sigh...... to 
no avail..... Let me quote part of the letter I received which 
borders on the ridiculous
"This will be corrected and the deductible will be removed from this 
claim as the patient named on the prescription id Michael Robinson 
and there is no Michael Robinson on this plan
sigh..... still no reimbursement for "Lily's" strips.
I called Safeway and verified that they have this prescription 
number, 8182085, listed a patient name Michael Robinson. Please 
review the prescription copy that I previously mailed to yo and also 
the one you mailed to Bluc Shield. You will see the name of the 
Patient is not Lily. We cannot process this claim with the name of 
the patient as Lily when the prescription does not say Lily.

duh..... In my opinon they are not clueless, merely working their 
profit center to deny legitimate claims. Anyway, at this point I'm 
beginning to get really annoyed. It's been a YEAR AND A HALF and I 
have not been able to get any movement from these turkeys!! At this 
point I remembered seeing in the paper a press release from some VP 
at BS that they were making a concerted effort to improve the quality 
of their (crappy) service so I called the corporate office and tried 
to get a name. I contacted some innocent fellow and unloaded the 
entire story on him pointing out that if I could not get this matter 
resolved satisfactorily I'd be happy to make a press release of my 
own about how the "little guy" had to sue BS of Calif. to get 
reimbursed for $60 buck for his daughters diabetes supplies. The 
previous day I'd already sent a letter to the BS Grievance Committee 
and a demand letter to the Agent for Service of process. The bright 
side of the story is that the guy I talked to actually did something 
about it. I got a call today at about 1:00 from a lady in the 
(coincidence) Grievance department -- no, she has not seen my letter 
-- responding to a call from her supervisor to "take care of the 

I guess the moral to the story is that all's well that ends well. 
YOU MUST STICK TO YOUR GUNS when dealing with these
insurance companies. In this case, the contract of insurance AND 
state law say that diabetes supplies are covered and will be payed 
for. It sure is a pain to have to wait almost 2 years to have it 
happen though.

email @ redacted
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