Anthem BCBS: Finale

And in the final iteration of this long tale of woe regarding a peon “David” facing down the “Goliath” insurance company,…..

I received a package in the mail last week.  The contract was the one I had chosen and it was provided to me at level 1!  I think that means I won!  I don’t want to gloat too much since “they” are still much larger than I am and since this may just appear that I have won, although I did go through the policy carefully and it did seem to provide the insurance I thought I had chosen.

I also received my first bill which was more than the premium I was told I would be charged.  I called to find out and was told that they had started my coverage back in July, so the charge reflected six weeks of coverage.  I told them that I had only just received the package.  How could I be charged for six weeks?  The very helpful person on the other end suggested  that all I had to do was send a fax informing the [entity] at the telephone number provided when I would wish the coverage to start and the date would be changed.  Wow.  Okay.  So as of August 15, I am once again covered by insurance.  Phew!

By the way, I also want to thank President Obama for pushing the health care initiative through.  I do not know whether I would have had the same outcome if this were not part of our present landscape.

Insurance Companies: Got you ….. (cont.)

Jim Dubel demonstrating adjustment protocals

Jim Dubel demonstrating adjustment protocals (Photo credit: Wikipedia)

In my previous entry, I spoke about the big “fight” I am having with my insurance company.

I called my chiropractor who responded with: “I don’t think my letter is going to change your level because the insurance companies look at any chiropractic adjustment as a treatment.”  “Yes, Bob, I know.  But if you write them a letter letting them know that I have not had a repeat of my situation in 2006, then they will know that my visits to you are not associated with that back issue.”  “But the insurance companies will ask to see all my records of all your visits.”  “Okay.  That should prove the point that I was visiting you was for other things?”  “I don’t know if I can say that.”

At this point, I am recognizing that my chiropractor is accepting the insurance companies’ definition of what he does.  “Bob.  I go to you if I feel a twinge in order to avoid that twinge becoming something bigger.  That, in my book, is preventative.”  “Yes.  But it is not the way the insurance companies see it and believe me, our association has been trying to get the insurance companies to see it that way.  But they won’t and so I don’t think my letter is going to help.”  “What is your philosophical position on what you do?”  Silence.  Then,  “Well, let me look at your records.  Now my records only go back three years.”  “That’s fine.  I only need to show that the problem has not re-occurred over the last two years.”  I guess he felt comfortable with what the records showed, because I received the letter a few days later.

Then I went to my primary care doctor.  We talked about how the insurance companies require the doctors to record everything.  So if my doctor writes a prescription, whether I ever fill it or not,  the insurance company gets a copy.  And, of course, we know, that for most doctors, one can never leave a doctor’s visit without a prescription for something in hand.  In this case, the records strengthened my position.

I have since re-filed the application, with correct boxes marked and letters confirming that I am fine.  Now I await to hear what level they will place me.  As soon as I do, I will post.  If they do not move me back down to a level 1, though, I am not sure what I will do.

© Yvonne Behrens  2012

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