Monday, March 16, 2009

Common sense seems to be lacking these days

I learned something today. I learned that common sense is extinct. It's true. I had a phone conversation with my health insurance company today that if I had not been part of, I would not have believed. I called them because I received a bill from my primary care physician with the following explanations as to why they denied my claim:

01/13/2009: denied, cannot identify patient as their insured (This was taken care of. They screwed up paperwork, and we resolved it in Feb.)

02/16/2009: denied, Anthem states other insurance is primary (I have no other insurance)

So, I called them thinking that it was just a mistake. Here is how the conversation went. (Paraphrasing slightly)

"Hello...this is so-and-so, how may I help you?"

"Well, you can tell me why my Dr's visits were not covered. I have a statement from my Dr's office stating (read above). I have been dealing with this since January and need to get it resolved"

"Well ma'am it appears that we have a letter here from August 2008 stating that you are insured with a different carrier as your primary. The letter states that from January 2006 until now you have insurance with another carrier"

"Excuse me? You are going off of a letter that was sent to you in August 2008?"

"Yes Ma'am. This letter states that you have coverage now with another carrier as your primary"

"You have GOT to be kidding me. That letter is from August 2008. It is now March 2009. That letter can't tell you I have coverage now from another insurance carrier. It can't read the future."

"I'm sorry, but this letter states you have insurance through another carrier from January 2006 until now."

"No. It says that I HAD insurance from January 2006 until August 2008. That letter can't speak for now. It was written in August of 2008"

And the conversation went on like this for another 10 minutes. She just wasn't getting that a letter written in August of 2008 could not tell her that I have insurance with someone else now! I even said to her that common sense would tell her that the letter is outdated. Her response was that "The letter says blah blah blah" GAH!!! I wanted to poke my eyes out with my pen by the time I was off the phone with her.

So, all in all, common sense did not prevail. I have to get a Certificate of Credible Coverage from my previous insurance and send it to Anthem. Then I have to wait for them to enter it into their computer before they will pay my Dr's bills. I truly feel for the next person I have to deal with at Anthem if they don't get this dealt with swiftly.

R.I.P. Common Sense. You will be missed.

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