Wednesday, October 21, 2009
BCBS doesn't pay when it should part 2
2009-10-20
4:30pm Called "Member Services" at 1-800-XXX-XXXX
Selected Option 2 then speak what you are among the following options I said "policy holder" (is where I fell. I’m not a dr…). It didn't understand me. I just stabbed the "0" and the "#" keys till it said it would transfer me to a representative.
4:32pm listening to hold music from the 1920's.
4:33pm John answered.
4:34pm I fully explained my issue to John.
4:35pm John doesn't think anything was changed.
4:36pm CORRECTION He says that it looks like on the internal site (there side) that they may have started making changes and are just waiting for one big adjustment to go through.
He stated that it can take time for them to show up correct on the external (the site I view) site.
He says that there is a total of $1632.11 in claims/Rx on there end being applied to my 1,500 deductible. This is even more than the amount on my end.
4:37pm He placed me on hold while he researches this to see what MEDCO has (whatever that means. Is that an internal system or a different insurance company?).
4:39pm He came back and advised me that they were supposed to do a mass adjustment.
But that it’s not showing that it's done on there end yet.
He's going to send it to there adjustments department and have them take care of it, by adjusting previous claims to get it down to the 1500 deductable.
When that is done if they were claims that have already been paid I would need to ask the provider for the refund (from those paid claims)
Which sounds like a nightmare to me.
Possibly even illegal since this is HSA monies were talking about.
I asked John how long this will take. He says it can take 2-3 weeks. He will call me and leave me a detailed voicemail of what claims have been adjusted.
I asked if he could email he said he will do that instead.
4:44pm end call
4:30pm Called "Member Services" at 1-800-XXX-XXXX
Selected Option 2 then speak what you are among the following options I said "policy holder" (is where I fell. I’m not a dr…). It didn't understand me. I just stabbed the "0" and the "#" keys till it said it would transfer me to a representative.
4:32pm listening to hold music from the 1920's.
4:33pm John answered.
4:34pm I fully explained my issue to John.
4:35pm John doesn't think anything was changed.
4:36pm CORRECTION He says that it looks like on the internal site (there side) that they may have started making changes and are just waiting for one big adjustment to go through.
He stated that it can take time for them to show up correct on the external (the site I view) site.
He says that there is a total of $1632.11 in claims/Rx on there end being applied to my 1,500 deductible. This is even more than the amount on my end.
4:37pm He placed me on hold while he researches this to see what MEDCO has (whatever that means. Is that an internal system or a different insurance company?).
4:39pm He came back and advised me that they were supposed to do a mass adjustment.
But that it’s not showing that it's done on there end yet.
He's going to send it to there adjustments department and have them take care of it, by adjusting previous claims to get it down to the 1500 deductable.
When that is done if they were claims that have already been paid I would need to ask the provider for the refund (from those paid claims)
Which sounds like a nightmare to me.
Possibly even illegal since this is HSA monies were talking about.
I asked John how long this will take. He says it can take 2-3 weeks. He will call me and leave me a detailed voicemail of what claims have been adjusted.
I asked if he could email he said he will do that instead.
4:44pm end call
Labels: BCBS, billing error, HDHP, Insurance
# posted by The Owner of This Here Blog : 4:07 PM
