April 21, 2009

They keep on coming

There are two topics that seem to receive a steady stream of comments on this blog. My entry on Edmonton garners a smattering of comments every few months, usually giving E-town a huge thumbs down. The other entry concerns my tribulations with BCBS and here I receive a steady stream of sad stories all of which point to the horrors caused by some branch of BCBS such as my least favorite one Horizon Blue Cross Blue Shield of NJ.

Along with the comment posted above, I got this one asking me to reveal the email address of the PR director of BCBS NJ. In the past I advised folks to google it to find it. But I just tried and it is actually a bit harder to find and I wonder if I should post to one of the many press releases that exist on the web with this information?

I hope thats some with some sort of time and lots of anger (toward BCBS) to start a website specifically geared toward and against BCBS. Call it Blue Cross No Shield (I think I actually own that and am pretty proud of the name) or something of that nature and throw up some blog and post horror stories in the style of the consumerist. There will be no shortage of them, especially if the blog is national in scope.

Get a mailing list going and start a fax campaign among many others. Share contact information about public relations directors and Other People in Power, tips and advice on fighting them, and perhaps even move to the next level of organizing.

I am not sure writing this here will do anything to inspire other and I would love to do this sort of rabble rousing as I get immense pleasure from doing so. But I simply am in the red when it comes to time. But I hope that some of the folks that have posted comments on this blog take the initiative to start a larger campaign (or someone can point me to an exisitng one).

update: Now that I think of it, The Consumerist should really take up this cause and devote a section JUST to health insurance. They are already a brand name of sorts with lots of eyeballs on the site, everyday.

January 20, 2009

Google it

Category: Blue Cross Blue Shield,Blue Cross Horizon — Biella @ 12:43 pm

So 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 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.

Wow. I also got an email from someone else also undergoing some horror who has asked me for the email of the public relations director who had emailed me many moons ago. Normally I would feel somewhat guilty giving it out, but given that BCBS is seriously causing a lot of problems for people all over the country, I think it is important that top executives in the company know they are causing havoc and financial problems for scores of peoplethis one is pretty horrible as well . Second, the information is already public and so one can easily find this person’s name by googling BCBS Horizon public relations director (You will get his name) and then google his name and you will get his email and phone number.

Good luck. If I were not a professor and were financially secure, I would definitely spend all my time on health insurance reform activism (and kick some serious ass, since I really enjoy that type of political work). In the meantime, I will help in the little ways I can and hope that this administration, which is a vast improvement over the last, will also rattle the health insurance industry as well. There are also groups out there doing great work, so if you are into reform, do lend them a helping hand if you can!

January 18, 2009

Blue Cross No Shield

After two years of phone calls, nasty emails, filing claims and reports, Blue Cross Blue “Shield” of NJ finally ponied up every last cent of cash they originally did not want to pay. Since the ordeal began, many BCBS customers left comments here where I chronicled my plight and many have also sent me emails as well. In the end, I think I was successful mostly because I had the email of the director of public relations (he made the mistake of emailing me) because well, I would send him these emails and I think he just did not want to receive anymore.

Recently I received an email from Reynold Weidenaar with a pointer to his webpage where he is also chronicling what is happening with BCBS since they want to deny coverage for physical therapy. This is great and more folks need to do this exact thing, which is chronicle every last detail in a public place. In the end, they have a lot of paperwork and we need to turn it back to them and in very large numbers.

November 3, 2007

On Bats, The Suckage of American Health Insurance and Paperwork Warfare

Two nights ago I was having dinner with a colleague who recounted a truly horrible experience he had with the modern-day American health care “system.” While in Montana over the summer, he got bit by a bat and well, as a result, he and his entire family had to get rabies shots. These shots are hard to get and priceeeeeeeeeeeeeeeeeeey. The final bill was $ 20,000 and his NYU based health insurance, United Health Care is claiming they are not responsible!### Like getting bit by a bat and the possibility of rabies are not bad enough. Isn’t the point of health insurance to take care of the unexpected??

Someone also pointed me to The Daily Kos’ wrangle with BCBS of California and well, they picked the wrong guy to mess with given there are so many many many many eyeballs tuned to his blog, everyday (just check out the number of comments). I wonder if the public relations director will contact him as they did with me after I blogged about my trials and tribulations. I certainly don’t have the audience and readers he does, so I am always surprised they ever contacted me in the first place.

The Daily Kos also provided a link for a site that I was thinking of creating if my problems with BCBS were not solved (glad to see someone else has) called Sick of Blue Cross. I personally like the name I came up with a little better Blue Cross No Shield but the important thing is that a site like that exists and it is very good site, design and content wise. There should be a site created for every health insurance company and they should federate and pool resources to gain more visiblity.

While I am not hopeful that the health insurance industry will change within, I think mounting and steady consumer pressure can do a lot to force the industry to change their awful ways. And while I think the bad publicity is a key part to putting pressure on the health insurance to change, I actually think that the power of the consumers also can come from elsewhere, and this elsewhere is overwhelming the administrative channels within and outside of the health insurance. The gist is if they send us a lot of (useless) paperwork, send them A LOT of paperwork back.

On the Daily Kos, a lot of people noted that things got moving when they complained to the Department of Banking and Insurance. While my own complaint to that department did not produce any immediate fruit, it did get the ball moving for the appeal process, which eventually panned out for me. That is, I learned a lot and started to get decent customer service. Doors opened.

Now, it took me weeks to find out that I could complain to the Department of Banking and Insurance and I am sure many find themselves in that situation of walking in a no man’s land of confusion and frustration. If more and more people know that you can file a complaint to these Departments (and why are doctor’s offices not relaying this information??!!), they and the health insurance companies will get inundated with that which they love to inflict on us, paperwork.

This may slow things down for you but at a certain point, state governments will get the message that something is deeply wrong. So, people MUST use these channels and overwhelm these agencies with complaints, faxes, emails as this is a powerful and very material message that something is deeply wrong and broken and must be fixed.

Also, send faxes and letters to various departments in your health insurance company (appeals, customer service, medical director’s office, public relations office…) get people’s email’s and send them emails. Inundate them with a barrage of administrative paperwork. If they are not being helpful, send a fax or two a day concerning your case until you get clear answers. While individual faxes won’t make much of a difference, imagine if there are 300 a day coming in or 3000…. This can work with the numbers are there and I have a feeling that the numbers Are There.

So spread the word for housebreaking your health insurance and push the paperwork back on them.

October 26, 2007

Should it stay or should it go?

Category: Blue Cross Blue Shield,Tech — Biella @ 12:38 pm

What a week. Most notably, I am still in a state of partial disbelief that my case with Blue Cross Blue Shield is now on a path toward resolution and I don’t have do battle with them, or at least in the same vigorous, soul-crushing way I have been engaged in since May (they still have not paid all the bills but at least part of them are resolved).

But the very same day that I received the good news about BCBS, I received not so good news from my dermatologist about the black-blue mole that lies right under my left eye. He wants it gone, removed.

So my whole fight with BCBS concerned claims over pre-existing conditions related to my moles. My claim was that I never had a problem with them until I had BCBS insurance and that is indeed the case. Soon after I first started having problems, I went on mole patrol and found a suspicious mole on my sister, which turned out to be melanoma. Now whenever I see a dermatologist, they all say, given my family history, given I grew up in the tropics, and given the odd size and very dark color of my mole, that it has to go. In fact the last dermatologist said with the firmest of tones: “there is no doubt in my mind that it must be removed.”

The words stung because, well, I am pretty attached to the mole. I have lived with it for my whole life and it is fundamentally, even if somewhat mysteriously, linked to my sense of self. If it goes, I would feel like a very important part of me would also vanish.

On more prosaic grounds, I can’t help think that part of the drive to remove such a spot is just part of somewhat unhealthy social trend toward measuring most everything in finer and finder gradations of risk. Given that this mole is on my face and I see my face at least 2x a day in the mirror, I would probably catch anything if it started to change but given our “risk society” it is unsurprising that every American dermatologist keeps saying it is time to bid adieu to it. Given my background in medical anthropology I can’t help conceptualize all this advice within these much larger social trends and then I go back and forth endlessly in my head as to whether I should remove it because it is safe and right and sound or whether I am caving in to somewhat irrational trend toward the risk management of everything.

Finally I fear my insurance company again. Though I have a good job and decent insurance, I may not have good enough insurance for what this procedure entails.
Because of the size and location of the mole (large and close to my eye), if removed it must be done by a plastic surgeon. And plastic surgery in the US and plastic surgery in NYC costs a very pretty penny. While I would plan on getting pre-approval for the surgery, I somehow have the feeling that they will not pay the full cost and I am going to be left with another bill. And I am trying to stop the unnecessary onslaught of bills.

So should it stay or should it go? I bet that I will lean toward the latter but not without a lot more thoughts, internal cries of resistance, and sense that even if I decide it is the best thing, I will lose a small piece of myself once removed…

October 17, 2007

My Ongoing Saga with BCBS

So here is a real (and positive) update.

So today I was on the phone with a very kind BCBS employee to schedule an in-person appeal meeting where I would present my case to a group of doctors (not affiliated with BCBS). Thankfully on the phone she mentioned that the only pre-existing condition left was an allergy and I was like, “no, how about all the skin stuff?” (this list is too long to list) and she was like all of those were overturned in August and so are not considered pre-existing conditions.” I was shocked and thrilled. She then faxed the letter that never got to me because it was sent to an old address in NJ (that I had changed this summer) .. So now we are moving somewhere good…

More soon but I wanted to pass on the good news!


It is clear to me that a “clearinghouse site” for complaints against Blue Cross Blue Shield would yield a lot of traffic. My post complaining about my problems with BCBJ Horizon of NJ has received constant comments with people posting their horror stories.

I have not moved to create such a site yet, because I am hoping that the outcome of my appeal will be positive and that I can report that going through the appeal process as they set up can lead to fair and just outcome.

But the frustrating thing is 3 emails and 2 phone calls placed this and last week to inquire simply about the status of my appeal has been met with a wall of silence. Frustrating…. I am going to try to contact them again this week and if not… I will have to file another complaint with the dept of Banking and Insurance over their inability to respond to me about the appeal process.