Member Services Representative -
I apologize in advance for the tone of this note, but I am at my wit’s end. I only see two doctors regularly, both out of necessity. Dr. N was paid by Healthnet for one visit without any problems or need for my intervention. After that, however, things went all pear-shaped. I have had to send a form letter — idiocy, really, as it is not at all difficult to see between insurance companies that my condition is pre-existing, and that I have never been without coverage — basically stating those two things. I sent this letter, along with supporting documentation, including past insurance proof and copies of every claim, for each doctor with charges being contested — Drs. G and N. I sent it registered mail, so I do have proof of that package being rec’d by your office. Still however I am hounded by claims that I didn’t supply the form… but oddly enough, both doctors now have claims that have been paid! Do I have to fill out one of those @#$%@#$% forms for every claim? If claims for both doctors are now being accepted, what am I missing? It is horrible that any payments were held based on a form I only needed to sign to begin with, but to have payments, and actions on claims, move so slowly is horrible, as it impacts my relationship with the doctors’ office. I have never had this problem before, have never been asked to jump thru so many hoops in order to get coverage, and I have switched insurance companies a handful of times. Please find out for me what the remaining problem is on the following claims, and what worked for the other claims for the same doctor that didn’t work for these:
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Just for the record, the fact that HealthNet will also not cover my medication (Lexapro), which I have been using successfully for over 4 years (3+ years before signing up with HealthNet) without having my doctor contest the matter, no doubt because it is not yet generic and might actually cost HealthNet some money, is also disgusting. It is a good thing that I am double covered via my husband’s place of employment, or I would be in financial trouble.
Again, I am sorry to the staffer that has to read this, but it is hard having to fight to get the benefits for which I am paying. If I had to do as much to be allowed to leave the grocery store with the food I’d already paid for, the store would be out of business in a day.
Disgruntled,
JustKristin
Oh Kristin! I hope that this letter, artfully written, will help you get some action! Dealing with insurance nightmares is never fun. It’s a stupid, waste of time, if you ask me! They just need to DO THEIR JOBS and stop trying to screw people over. I HATE having to fight for good medication too. That makes me more angry than the other situation. Just think, what happens to the less intellectually fortunate? Good luck!