$330 for a one hour office visit...

[cynatnite]

This was for a pap smear which is considered preventative medicine by our insurance company Blue Cross/Blue Shield and should have been covered 100%. Because I told the doctor about PMS issues I've had since I was in high school that I've never spoken about with another physician the claim was reclassified as a pre-existing condition and denied.

We pay $552 per month for our insurance which is supposed to cover our entire family. Every claim we've had to file at least twice. Getting BCBS to pay up is like pulling teeth. If we could afford the risk of doing without insurance I would dump them.

Despite having what's supposed to be considered good coverage and paying out the nose for it...our medical costs outside of that insurance continue to rise regularly.

This is one of many reasons why I hate the medical insurance industry and why I have little use for them.

[Warpy]

1. Call the doc and say your claim was denied

and ask him/her if there's any accommodation that can be made.

Docs are the good guys in this drama. Most will reduce the bill.

Insurance companies are pure, unadulterated evil whose sole purpose is to deny care in order to wring money out of us.

[cynatnite]

2. Been calling for two days now and still not getting my calls returned...

:banghead:

Called the insurance company and a very nice woman said they'll refile it again. :eyes: That's what I'm always told by them. I hate 'em.

[hedgehog]

5. Don't be surprised if this time the claim is paid.

I've heard enough stories to convince me that there really are pressure to turn down claims that are valid. Only the people who complain get their claims paid.

[AnotherGreenWorld]

13. Your doctor won't even do as little as to return your call?

Wow, what a great guy! :sarcasm: Typical doctor.

You would probably have better luck if you pretended to be a pharmaceutical rep. Doctors love pharmaceutical reps.

[cynatnite]

15. I have to talk to the lady who deals with the insurance claims...

doctor's don't usually handle these things.

[Cleita]

3. You have just become another victim of our healthcare crsis. This

is what Michael Moore dealt with in his movie "Sicko". It was about people who thought they were insured and then found themselves without meaningful health coverage because of the machinations of the health care industry in pushing out those insured who have real health issues and are becoming a liability to their bottom line.

[The Vinyl Ripper]

4. Denying the claim is the default action of a lot of insurance companies..

They deny *all* claims the first time around and then "generously" decide to accept them if you raise enough hell about it.

It really helps their bottom line..

Why do you hate capitalism?

[madrchsod]

6. i never had any problem with mu bc/bs in illinois

i`ve had issues for years and they never declined anything. my wife and i had different insurance companies and both policy's paid over 150,000 so i ended up paying nothing. then we both had bc/bs and no problem with pre-existing..now she carries the insurance so the new company is contesting my latest 28thousand + bill...we pay250 per month
i paid over half my take home pay for my bc/bs insurance but i never paid a dime on any operation..what a great trade off...found out to buy the same insurance it was around 450 per month

i am glad i`ll have universal health care in 4 more years

[cynatnite]

8. Our BCBS operates out of Virginia...

That could be why we're having these issues with them. They're a different part of the network. I was told some time ago that they operate under different rules.

I wish we had the kind of care we had when we were active duty. Excellent care all around without the hassles of insurance and medical bills.

[spotbird]

14. That's who I have,

and as far as paying the part of claims they're obligated to pay, it's the best insurance I've ever had. The people who answer the phone are even nice.

The costly problem is copays and deductibles, but that's the negotiated plan so it's not BC/BS's fault.

[newportdadde]

7. I got charged 90 bucks for a less then 5 minutes office visit.

I had come back for a follow up blood test to check my cholesterol level. I was expecting to get a blood draw and be on my way, typically small lab charge.

Right before the draw my Dr walks in, shakes my hand, goes over that I'm here for a cholesterol check and then lists the 3 big risk factors for high cholesterol. Then he leaves. It was maybe a total of 3 to 5 minutes of time. He charged an office visit that before insurance was applied amounted to 90 bucks.

Rip off.

[CanonRay]

9. You're lucky there's no inflation!

[PA Democrat]

10. File an appeal. Check the denial form and there should be an address

and info on the deadline for doing so. Put it in writing. You can also file a complaint with your state's insurance department. That's what I had to do to get a claim paid.

The insurance companies are criminal enterprises. I know that in my case there was absolutely NO justification for turning down my claim. The filthy pigs tried to claim that a doctor's visit I made 3 years ago complaining of abdominal pain which was due to a bladder infection, was proof that my cancerous colon polyp was a preexisting condition. So I got slammed for $4300 in bills for my colonoscopy. I won my appeal, but the pigs KNEW they were unjustified in denying my claim in the first place. They should be in jail.

[MissB]

11. Yes! File an appeal!!

[tandot]

12. What does PMS have to do with getting a pap smear???

How can they deny something like a pap smear???

This country is so ready for Universal Health care. For-Profit health insurers are making money by denying as many claims as possible. They are not there to keep or make you healthy, they are there to take your money and get rich.

[MissB]

16. My doctor always asks me about unusual symptoms related to

my period when I go in for a pap smear. So I could see where the OP would discuss PMS issues with her doctor at that time. Things change over the years - PMS gets worse in some, better in others.

[tandot]

18. My doctor asks those questions, too.

However, having PMS does not lead to cervical cancer or HPV and should not prevent you from getting a regular pap smear.

I would ask Blue Cross to explain why PMS is used to deny coverage.

[MissB]

19. Ah, I get it.

I thought you were asking a completely different question. :rofl:

[toadzilla]

17. thats what I was wondering...

I've been hearing so many stories like this lately. It seems like the insurance companies are trying to suck every last penny out of us while they still can.

[npincus]

20. and Vitter's prostitute charged $300/hour!