Well, “There is no joy in Mudville”. Health Net, my insurance Co, pounded some more nails into my coffin today. They have denied my appeal for payment of about $60,000 to UPMC. UPMC has started collection proceedings. Credit likely to be ruined......
I have not heard from the Insurance Commissioner yet, but I am sure that he will be by with some more coffin nails. I guess that the commissioner and Health Net belong to the same club. I was foolish to believe any different. The insurance co. is saying, “our phone reps. Are so well trained, that they must have given you the correct information, and it is right there in the notes”. I have been trying to get information on the existence of a recording of the pertinent conversation regarding this.... 5 weeks and counting.... They continue to give me conflicting directions, and excuses. If this recording exists, and it supports my argument, I am afraid that it will become lost. What they have done seems like such a blatant abuse of the rules, it is hard for me to believe that this is happening. The only avenue left is a lawsuit, but I don't know how I will find the energy to continue. I guess that they know that they are dealing with sick people, and have no problem using that to their advantage. I suppose that “waiting for the patient to die” is good business.
I still have high hopes regarding the property that is tied up in BK. It seems impossible that my “motion for relief” would be denied, but I have been wrong before. If I can get the property out of the BK, and proceed with the foreclosure, I may be able to avoid financial ruin.
I think that the only way out, is to write a hit country song...... Old, Broke, Sick, and Single..... Has a nice ring to it..... I guess that I can always downsize, and get by.
5 comments:
So sorry to hear about your insurance travails...I can't believe Healthnet is treating you this way. What liars they are. AS IF UPMC would have performed the surgeries and treated you if Healthnet had told them they would only pay $750-$1000 a day for inpatient care. And AS IF you would have gone to UPMC if Healthnet had told you they would only cover that much of your treatment. Jerks!
Is there another level of appeal through your insurance company or were you denied at the highest level you could go? Assurant Health had 3 levels of appeal before it was necessary to go to the state insurance commission.
Is there a cure for "blood boiling"? Cause I got it bad.
Your attempt at humor did get me to laugh out loud when I saw the pictures. Tim too! Hilarious and I could almost see you doing it.
I think maybe you should consider a lawsuit - check this out. Facts are different but the behavior of the insurance company is no less reprehensible in your case. Rather than recsind, Healthnet just finds a way to not pay for covered illness through lying and deceit.
http://www.latimes.com/business/la-fi-insure23feb23,1,2568706,full.story
http://www.huffingtonpost.com/2009/09/17/insurance-company-must-pa_n_289841.html
Hi Peg,
Thanks for the links.
Yup that was my last appeal with in the insurance co.
I will certainly be contacting the lawyer that handled the case against Health Net.
I wonder if the people that turned down my appeal got a bonus for it.
I don't know how those people sleep at night, I hope that karma really exists.
Wow, I guess I worked for the wrong company. I never got any bonus for denying a claim...just grief. Much easier to pay than deny and much less paperwork, at least on my end.
If there is a recording the insurance company has the obligation to release a transcription to you upon your written request. They might try to tell you that the recording is proprietary which is BS because you are a party to the recording. Be sure and cc the hospital of your request.
Your who ordeal makes my skin crawl and blood boil. Wish I could waive my magic wand and make it all go away. Hugs.
I guess that I don't have any confidence that they will do what they are obliged to do. I think that a recording that favors my argument will just disappear..... Oops, we are so sorry, but accidents happen, and we always have the "notes" to prove our point.
Anyway, I hope that you are right. Thanks....
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