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Why health insurance in America is all f'd up:
I call @Carefirst: "Do you cover CPT codes ___ in the following circumstance?"
Carefirst: Yes, we pay 70% of the allowed cost after the deductable."
Me: Ok great. What is the allowed cost?
Carefirst: We can't disclose that.
I call @Carefirst: "Do you cover CPT codes ___ in the following circumstance?"
Carefirst: Yes, we pay 70% of the allowed cost after the deductable."
Me: Ok great. What is the allowed cost?
Carefirst: We can't disclose that.
Me: (six weeks later): Why aren't you covering these services?
@Carefirst: .... because we only cover 70% of the allowed cost after the deductable
Me: Right. Costs greatly exceeded the deductable. So what was the allowed cost?
Carefirst: we can't disclose that.
@Carefirst: .... because we only cover 70% of the allowed cost after the deductable
Me: Right. Costs greatly exceeded the deductable. So what was the allowed cost?
Carefirst: we can't disclose that.
Me: So... you will pay 70% of allowed costs, but you won't tell me the allowed cost?
Carefirst: Right.
Me: So how do I know if you are providing benefits as you are contractually obligated to do?
Carefirst: . ..
& the worst of it is, I will never get back the time spent on this.
Carefirst: Right.
Me: So how do I know if you are providing benefits as you are contractually obligated to do?
Carefirst: . ..
& the worst of it is, I will never get back the time spent on this.
Executives at health insurance companies should be required to devote one day each week to attempting to decode their own policies and appeal their own claims denials.
