Tuesday, August 09, 2005
Does Pacificare Care about the Pacific Ocean?
Today I experienced what is commonly referred to as a wild goose chase. In the end I caught the goose. Basically I am dealing with one of the worst medical insurance companies out there IMO. They are called Pacificare. Stay away, far far away. I am still feeling the repercussions of the Dr. jamming a camera down my throat and telling me I'm fat. With over $7000 in medical bills from that one time, my insurance company decides to pay nothing. Instead of giving the customer the benefit of the doubt they make all the wrong assumptions. First they said I still had existing insurance which was wrong. So they made me get a letter from prior insurance company. Supposedly the prior coverage letter said I was covered until July 31 of 2005 by Aetna. Except for the fact that I had quit that Job in August of last year. Then since they determined that I had a break in coverage that I had to enter the world of medical records hoo ha. Basically they made me, the patient, request records from all of the doctors and labs for every single visit and procedure. Then I was to tell them where to send the records to. Ok, it is abnormal to do that anyways. Shouldn't the insurance company do that? Isn't that part of their job? So the doctors and hospital I talked to told me I needed to get pacificare to notify them and they gave me their address and how to do it. So I had to talk to pacificare again and tell them that what they told me to do they need to do. Then they told me I had some pre-existing conditions and they didn't need to pay my office visits because I had high blood pressure even though I had already paid a co-pay and I no longer have high blood pressure. Also if being fat is a pre-existing condition then so is being alive and we shouldn't be covered at all. Then they basically paid $20 out $880 for one of those bills from the march procedure because I still needed to pay a deductible. But that was where they slipped up in their plot to pay nothing. By paying $20 they proved that they already had medical records for the whole procedure. I called the billing company and they said they sent them medical records in June. I told that to pacificare and finally they agreed to continue processing those big bills. Man, it took over 2 hours and 7 phone calls, 4 to Pacificare to get things straightened out. And I still think I am being shorted by them. I think it has to do with how untrained those customer service people are. Every call I made they asked me to get medical records when they had them all along. I had to make all those calls at work in front of my computer because they are only open when I am working. Now all my co-worker's know I have over $7000 in medical bills. The whole world might as well know now. Thanks Pacificare!
Thought of the Day
"He's a doctor. You gotta pay what he says."
"Oh, no, no, no. I pay what I say."
- Jerry and George, in "The Ex-Girlfriend"
Thought of the Day
"He's a doctor. You gotta pay what he says."
"Oh, no, no, no. I pay what I say."
- Jerry and George, in "The Ex-Girlfriend"
Comments:
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That sucks. It all comes down to one thing...any guesses.......MONEY. The people at the insurance company aren't stupid. They're hoping you'll figure it's too much trouble and just pay the bills. Good for you for fighting it. So far, I've been very fortunate with Aetna. There's always a co-pay, but it usually doesn't amount to anything.
Peety
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