One such encounter went like this:
Me: “Hi. I’m calling about my daughter’s ambulance and hospital charges. I haven’t been able to reach my grievance coordinator about the appeal.”
Representative: “I can help you.”
**Me: **(Genuinely excited.) “Great!”
Representative: “Oh, I see your daughter turned 18. I can’t discuss her information with you.”
Me: “I sent a release of information form by mail, fax and email. I also faxed our conservatorship papers.”
Representative: “I’m sorry, it’s not on file. What office did you send it to?”
Me: (I give the information.)
Representative: “That’s the wrong fax number. Let me give you the correct one.”
Me: “I’m not inventing numbers out of the ether. This is the third new fax number I’ve been given. Are the address and email inaccurate too?”
Representative: “I’m sorry, but I can’t discuss your daughter’s claims with you without this information. Can you put her on the phone to give verbal consent?”
**Me: **“I can’t put her on the phone. She’s currently in a treatment center and has no access to a phone, which is why I have a conservatorship to help with her medical care.”
Representative: “I’m sorry, ma’am. There’s nothing I can do without the forms or her verbal consent.”
Me: “Who do you think pays the insurance premium and all her providers? I’m just trying to settle her claims, and I don’t know what we owe without access.”
Representative: “I can only answer general questions.”
Me: “OK. From the bills I’ve received, we’re being charged out-of-network fees for the ambulance, ER, ER doctor and hospital.”
Representative: “Was this out of state?”
**Me: **“Yes.”
Representative: “Hang on, I have to transfer you.”
I was on hold for another 15 minutes, and then got cut off. I called back, was transferred twice and then repeated a version of the above conversation before resuming — with a grievance coordinator!
Grievance coordinator: “The ambulance and ER facility were both out of state and out of network.”
Me: “A treatment center called for an ambulance. I wasn’t given a choice of who responded or where they took her.”
Grievance coordinator: “They used out-of-network providers.”
Me: “They dialed 911. No one stops to ask the closest ambulance what their network status is.”
Grievance coordinator: “They did transfer her to an in-network hospital, but the physicians were not participating providers.”
**Me: **“Under the No Surprises Act, insurance must cover all providers in the case of an emergency, whether they are in network or not — even if out of state.”
(There was a long silence.)
Me: “Are you still there?”
Grievance coordinator: “Yes, ma’am. Once you get the conservatorship papers to us, we can look at those claims. Is there anything else I can help you with?”
Me: “Apparently not.”
“Death panels!” the conservatives shouted. “The government will have death panels!”
The rubes ate it up, not realizing they had death panels the entire time and paid more for them.
Not to mention the part of the bill they were referring to was paying doctors for end of life counseling, like living wills, which help people die with comfort and dignity.
Seriously. The real Obama Death Panel is a lone worker mass-clicking “not covered” all the way down a spreadsheet that has your care as a line items.
I also like doing this juxtaposition:
Repubs under Obama: “death panels are going to kill our grandmas.”
Repubs under Donald: “sacrifice all grandmas to the rising line.”
And the only death panels were all the insurance company death panels that already existed all along the way
rubes
I call them Rubels
Courts should find insurance companies liable for billing mistakes that you have to spend your time and resources to correct. Compensation should be 100 dollars a minute.
Brilliant. Unfortunately the insurance lobby owns Congress.
Hey - we should get our own lobby and outbribe them
Kickback congress for 1% of those fees.
Conservatives love to say free market works, shop for best price, blah blah… When you are having a heart attack, you don’t stop 911 from sending help until you shop around for the best ambulance service… You take the closest one, go to the closest hospital, and get service from the doctor on call.
Fuck insurance, we should have Medicare for all by now.
On top of that, shop for best price? During the one month of open enrollment where it’s allowed? What if the providers all leave the network halfway through the year, as regularly happens? They have literally made it impossible to shop around for the best price.
Conservatives are all liars. I mean, you know that. But the academic theory of the free market valuing things correctly requires an assumption that people can go without the goods and services being valued. It’s not even a misrepresentation on this one. It’s just a straight-up lie.
Causing long term damage (requiring further treatment) is probably their ideal outcome.
Death is so… “you’ll stop paying us”
health insurance companies only profit when human beings suffer. full stop.
the only people rooting for these companies is either in on the take, or hasnt suffered their ‘service’ or are too rich to care. thus proving healthcare is for the rich only
I worked for a company who went with a cut rate insurance provider one year who basically denied or screwed up every claim. This required calls, faxes and hours wasted any time anyone had a medical procedure. The kicker was that the insurance company hours were the same as our company hours so all of this had to happen during company time. They went with a proper provider the next year.
Should call it death insurance not health insurance.
That’s called life insurance.
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Yes, they are. They don’t care about their customers, just the premiums they can rake in without paying out on.
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Being the person who pays the bills does not and should not grant that person access to another person’s medical records, even if that person is a parent. I get that you submitted the authorization in this case, but I am speaking generally in response to your comment which seemed to imply that third parties should be given medical information if they are the ones paying the bill.
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OP, you may be in lawyer territory. Not to sue the insurance company, though it may come to that.
A lot of these companies will give riff raff (you and me) the run around.
But once an attorney enters the picture, they have to get their attorneys involved and typically corporate attorneys aren’t cheaper than one you hire. So the incentive to resolve the situation quickly is higher.
At least for a short time. So a short phone call from your attorney to them will often get the attention of the right people.
Can confirm. I will never work directly with insurance on a difficult issue again. My attorney is worth every penny. He’s saved me countless hours of time and the endless frustration/desperation that comes with handling insurance agents. He’s also saved me a ton of money in the long run (but not the short run!).
There’s a reason Allstate is the most frequently sued auto insurance provider. They will give you the run around all day long until you lawyer up and then it’s, “Oh! Ha ha! Sowwy! We bunch of dum dums who no can read and no use kumputers good. We no know what happened! Here big check for you go away now.”
But for every person who lawyers up, there are probably 20 more who don’t. Fuck Allstate.
It’s an article in the Huffpost bro, the author isn’t here.
I get providers and insurance companies flagrantly violating ADA all the time with me and my housemate’s care. They don’t give a shit and nobody is holding them accountable if you don’t have money for a lawyer to threaten them officially.
Do you mean HIPAA?
Well certainly that too. But I’m talking about the Americans with Disabilities Act.
Wait until you find out other “legal” persons in your life lol
What?
How is this legal?
RepubliQan’ts
This has been a problem for decades longer than they have been around.
Wtf?
- Are you saying health insurance scams predate conservatives?
Or
- Are you claiming conservatives are somehow not to blame for our completely fucked healthcare system despite their extreme efforts to prevent conversion to a normal healthcare system?
Or
- Are you just being a bit pedantic about the use of the word “Republican” instead of “conservative”, since our most-conservative party has changed names a few times during our nation’s history?
If #1 or #2 is your meaning, allow me to debate your position.
Conservatives (including conservative neo-liberals) are the direct fucking cause of this situation. If they were removed from the equation, we would at least be on par with one of the 30 other developed nations. We are the ONLY developed nation on earth without healthcare, and the reason for it is conservative cockroaches doing the bidding of the billionaire class. That is the only reason.
The cure to our health woes is the eradication of conservatism. It really, truly is as simple as that. If we were able to cure the plague of conservatism, we would be rewarded with a normal civilization that includes a healthcare system.
It actually isn’t, but those in charge know our legal system works so slowly. So the companies already know they just have to delay and they’ll only pay a percentage of a fine for swindling patients. And instead of being accused of robbing, their legal team will get charges lowered and the company will just change its name and start over. Until the punishment fits the crime, the rich scams will continue.
Yup. They violate HIPAA all the time, too. Rules for thee, not for me.
Bingo. Which is why they comfortably hide using the infighting of the two party system. One party has to be willing to accept they’ll be doing most of the work to fix the situation. Up until now, they wanted us believing the task is Sisyphean and impossible, the truth is we can easily catch them with their pants down.
Quick reminder: only for 4 months of the last 44 years have the Dems held the admin, house and Senate, that triumvirate that lets them do anything positive without selling everyone out for the smallest of handouts.
That’s literally not true. Obama has both the house and the Senate for the first two years of his term, and he wasted them.
joe biden has done more with a house full of republicans and a gridlocked senate. Its amazing people still think obama was at all good.
It’s not but since the Government refuses to enforce it’s own laws, it’s up to individuals to pursue expensive and extremely long civil cases.
Oh you sweet summer child. As if that matters.
Unfortunately, the US will never change. This rabid individualism and savage capitalism is too ingrained in the country’s psyche for it to change.
Although I don’t believe that, i do believe the amount of needless suffering required to force that change is too damned high
mereo@lemmy.ca is correct. We’ll never fix anything in the US. I used to be hopefulbut there’s just now ay as long as people buy into the BS conservatives sell.
As someone who is taking Kaiser Permanente to court over their refusal to release documents, let me confirm that grievance coordinators are the most useless wastes of oxygen ever to steal air on this planet. Even having your lawyer send them the actual text of the law they are currently violating, they will refuse to do anything not explicitly outlined and approved by their policy. Fuck the law. Fuck common sense. If it’s not policy, it doesn’t matter.
Ignoring the law is a more profitable strategy then following it. Unless this changes, then healthcare companies will continue screwing people over.
If the fine for breaking the law is not high enough, the fine becomes the cost of doing business.
Insurance is a scam. Get hospitality bill as self pay and tell them to go pound sand. Lo and behold they will quickly work out a reduced amount and a reasonable payment plan
Unfortunately this isn’t an option for many folks, as they have insurance because there’s no way to afford the bills that they would be sending if one didn’t have insurance, even if a hefty discount was applied.
