June 8, 2007

Michael Moore wants to hear your horror stories

Not so long ago, I blogged about my trials and tribulations with Blue Cross Blue Shield of NJ. I got a very interesting response that I will blog about later today or tomorrow, though I can’t say the outcome has been to my liking.

While my problems with BCBS have not reached the status of truly horrific, I do think they are indicative of the how many insurance companies operate: with total lack of transparency and often, integrity (again more on this later).

For those of you who have had horror stories, Michael Moore is now calling for collecting your horror stories as a consequence of the American health care system and health insurance companies. Do take the time to make a video if you have a story to tell.

13 Comments »

  1. s/BBBS/BCBS/ ?

    By the way, the name, email, and website fields in the comment form use an unreadable yellow-on-gray; could you please style them to use the same black-on-gray that the comment body field uses?

    Comment by Anonymous — June 8, 2007 @ 5:45 pm

  2. Yea, let me take a look at it..

    Thanks, I also fixed the BBS to BCBS

    Comment by Biella — June 8, 2007 @ 7:18 pm

  3. Wow – after a one year fight to get them to pay “secondary” on my kids – My insurance pays first my ex-husbands pays second (more to the point not at all — gee BCBS strikes again) they had the nerve to DEMAND that I update my information with them (breaking current HIPPA laws) and providing them with information that they of course would never provide me with — ie flip side i provide them with my social security, but they can’t provide me with his etc — even though I still have his for reference….can we say how many hippa laws does a single mom have to break to get BCBS to play fair and just pay (it has been over a year)

    The parent company is :
    and a phone i found on the internet is: ignore the name etc prob not good anymore but was found under google search so not breaking any laws by passing on

    Wendy Marinkovich. Manager, Network Credentialing. BlueCross BlueShield Association. 225 N Michigan Avenue, 5th floor. Chicago, IL 60601. 312-297-6357 …

    Comment by JJ — June 25, 2008 @ 2:09 pm

  4. I had had Blue Cross insurance for more than a year before my low back pain set in and I could no longer walk or even sit up. After multiple calls to Customer Service with no response for days I phoned again and had the following conversation with the customer representative who tried to tell me the pain in my back was caused by a car wreck I had had 20 years prior to the claim.

    Shortly after this conversation I paid out of pocket for an MRI and discovered I had herniation in my low back. Blue Cross paid many of the claims more than 7 months later. Then, without notice, they then canceled my policy.

    Phone Interview 2005.
    (BC) –If there was a car wreck before than this would be a pre existing condition from that.
    (me) –Twenty years ago?
    –Mmm-hmm, yes, that is right.
    –TWENTY YEARS AGO?!
    –Yes. I am not a doctor, but, yes, thatís right.
    –So youíre telling me that if I had a car wreck twenty years ago and never felt back pain and was never diagnosed with having an issue with my back and nothing ever surfaces and now, twenty years later, Iím on the floor writhing in pain for no apparent reason whatsoever that Blue Cross naturally assumes it was caused by a car wreck in the nineteen-eighties and refuses to cover it?
    –Yes sir, that is correct.
    –Thatís ridiculous! Incredible! If I never felt pain before now and there are no records of my having pain how could you prove such a thing?
    –We donít have to prove it, weíre not denying the claim itís justÖbeing investigated.
    –For forever?
    –If thatís what they want.

    Comment by James — September 4, 2008 @ 10:53 am

  5. I had an accident in June. I was rushed to the emergency room on a Saturday afternoon. An Orthopaedic surgeon that was on call came in to set my bones. BCBS says that the physician was out of network and they paid $3900 of a $21,000 bill. I had NO choice and I was not in any shape to find out if the doctor was in-network. Seems illegal to me.

    Comment by Sally — January 20, 2009 @ 11:59 am

  6. Fight it. DO NOT pay. This is absurd. Email everyone who you can, appeal, go to small claims court, even hire a lawyer if need be. This does not seem right and it is way way too large of a bill.

    Comment by Biella — January 20, 2009 @ 12:41 pm

  7. [...] I am still getting a lot of comments on my blog about BCBS horror stories and recently this one was submitted, which seems particularly horrific: I had an accident in June. I was rushed to the [...]

    Pingback by Interprete » Google it — January 20, 2009 @ 12:43 pm

  8. My exhusband has had horizon bc/bs for many years, we have never had a problem with them paying for medical bills. Until recently, my daughter needs jaw surgery, BCBS after several months and several copies of sending records,they approve/ deny her in a matter of 2 wks. They are not denying it is medically nessecary. They believe it is a dental procedure not a medical. Her surgery requires her to have her jaw moved forward to relieve her headaches, chest pains and fainting, due to sever pain. I’m frustrated with the money we pay for premium and get a denial on medically needed procedures. Did I mention they sent out the denial letter 2 days before her schedule surgery.

    Comment by Gwen — July 20, 2009 @ 4:42 pm

  9. I have had ongoing problems with BCBS processing claims as secondary. I’m in a battle with them now over an MRI on 12/29/08…they have all they need but won’t process the claim…gives me promises but that’s all they are. Yesterday I sent a letter to the president (I think) of BCBS of Michigan…no response yet. I’m hoping he will do whatever is necessary to get the claim processed. I’ve been given dates that the check will be cut but the website continues to show the claim pending…Now they say it is a “system” problem. After reading the posts to this blog I am amazed that there isn’t a class action lawsuit against them…they really need to go belly up! They do not meet the code of ethics which you can pull from the website! And I bet that the folks that work there often scratch their heads about the moral decay of this country and yet they are part of it by knowingly giving people the run around! I bet some would even call themselves Christians!

    Comment by Carol — July 23, 2009 @ 6:10 pm

  10. I was diagnosed with prostate cancer in Dec. 2008, (next month will be a year). I’ve paid insurance premiums through my employer, “Food Lion” for 19 years. I did what I was told from BC and BS of North Carolina, “show my card, if accepted, no problem”. Well, next thing you know, inserts (permanent) were put in me when I was put under, and I had to fight for the next step, “MRI/CTSCAN”. I had to get someone in Human Resources involved. Later, after a delay, I sent a nasty email to BC and BS of NC. The head of the appeals division called me back and after asking me, “when were you diagnosed”, and I told her, December (this was May), she said,” WELL, IT COULD HAVE SPREAD BY NOW”. And I replied, “THANKS TO YOU PEOPLE”. She then tells me that “they don’t do Cyber knife and consider it “experimental”. I had to sit down! I told her, “this is the first I’ve heard this”. She tells me to appeal. I contacted the hospital, they were already working on an appeal they tell me. It was denied! I later told the hospital I wasn’t paying anymore bills. Sinai Hospital sends me an email telling me that, “they as well as BC and BS of NC were at fault, and just give us 1/2 of the money!!! After the appeal was denied, “Coleen” at HR calls me and then say’s, “Once BC and BS make a decision, they never change it”. I said, “then why appeal”????
    And last week my second appeal for Cyber Knife was turned down: I was enrolling in a “Clinical Study”. Our policy say’s that I’m qualified: “A Life Threatening Disease”. However, “BC and BS of NC denied me and added to this: “We consider it life threatening if death is imminent within a 2-year period”. So my appeal was turned down. I always thought that you tried to “kill cancer” at the first possible instand.

    These people should have nothing to do with being, “health care providers”. They should be in prison. Using .50 cent words and codemning people to death! Now what do I do, I think I already know the outcome of the next appeal, “Coleen told me”.

    Comment by Tim Roop — November 17, 2009 @ 9:13 pm

  11. I cancelled my Blue Shield of CA Supplement in January to go to an HMO. I had been with Blue Shield for 9 years and am in very good health. The HMO representative misrepresented the plan and I tried to go back to Blue Shield, which is legal. However, Blue Shield denied me because of “prior condition to Medicare at age 65.” What does that mean? I have not had a hospitalization, nor do I take medication other than Fosamex. Why am I being penalized for a condition that was over 6 years when I am in good health now and was when Blue Shield accepted me the first time.

    Comment by Robin — February 4, 2010 @ 8:26 am

  12. also we are having problems with Blue Shield of California. our son was born last year at home with help of a midwife. months before delivery I called Blue Shield twice to reassure our expenses will be covered and was happy to hear that, since Blue Shield does not provide a network for midwifes, they are treated like “in network” and 90% of our claim shall be reimbursed. we paid the midwife out of pocket $4500, a fraction of a hospital bill for a normal vaginal delivery. when we sent off the claim,after the birth, it got denied.the amount BS was willing to pay was$0!!!. we spent since then hours and hours over the phonewith BS customer service and writing letters to the grievance department. finally BS paid 1450 as a “band aid”, which is still not enough. what a scam, using the birth of a child as a platform to deny their obligations! this fight is not only for the money anymore, since we spent already more time than it’s worth it. but this is a fight for our rights.and we are not going to stop!

    Comment by Barbara — September 8, 2010 @ 8:34 pm

  13. We are having the same problem as the other individual regarding Emergency Room services and BCBS. I had chest pains 2 years ago in 2009, went to our ONLY hospital ER, and now, 2 years later, I am receiving a bill from Sheridan Healthcare for $700???? Moreover, we fully paid and met our $2000 deductioble. Apparently, ALL of the ER doctors and our only hospital, SGMC, were OUT OF NETWORK????? I’d love to know how someone in a vegetative, near death state, who has BCBS for years, is supposed to coherently negotiate while in the ER? The hospital of course blames this on BCBS and doctors not wanting to contract with them. This needs to eb a class action b/c I guarrantee all the folks in town with BCBS who go to the ER have no clue about their future unexpected major bills.

    Comment by Hilary Davey — January 21, 2011 @ 8:23 am

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