May 25, 2007

Pricefull and Priceless

$ 5000 medical bill (that insurance won’t pay for)
$ 450 water bill in Puerto Rico
$ 150 library fine for one lost book that normally costs under 20 dollars

Anxiety and rage from dealing with these ludicrous bills: priceless.

Ok seriously I am now dealing with these three things and it has been really really really unpleasant. I sometimes wonder if I was once a bad as* Roman tax collector by the name of Biella Plebius and now, reincarnated as Biella Coleman, I am suffering the karmic consequences of extorting people in the 3rd century A.D.

Other times I take a lighter approach to all of this and console myself that if nothing else, I am learning a lot. For example, as I had mentioned awhile back, Blue Cross Blue Shield Horizon of New Jersey is stalling and denying health insurance bills for my mole surgery. Because I had a pre-existing clause in my contract, they are trying to squirrel out of it. However, since I never had a pre-existing issue with moles, I am pretty sure they are required to pony up the cash but getting them to do this has been a Herculean, no Sisyphean task.

Since it was clear they were not going to pay if I alone was applying pressure, I was about to file a claim in Special Civil court (the bill is too high for small claims court) but I wanted to see if I had any other options. So hours and hours after diligent web research, I finally found on that I can file a complaint against my health insurance via the Department of Banking and Insurance. I am amazed that NO ONE in the doctor’s office, including those whose only job is to deal with health insurance, had a clue about this option.

And even when you go to the Dept of Insurance website it is not totally obvious that you can file a complaint (it is under the “file for assistance” category). But once I got in touch with them, they have been incredibly helpful.

Now, my detailed complaint letter is with them, and some other documentation and apparently they have an investigator on the case. I am not sure if this route will be enough pressure to get the job done but at least by the time this is over, I will be in the greater NY area so that I can move to the court option.

The take away lesson here is that if you are having any trouble with claims and health insurance, do do do do file a complaint with your state Department of Banking and Insurance. This is a great first option to use.


  1. That BCBS Horizon of New Jersey wouldn’t tell you about the Department of Banking and Insurance I can understand… but yeah, why wouldn’t the doctor’s office at least tell you about it?

    In any case, thanks for the tip! I have a Blue Shield policy myself. (So far no problems, but then again, no claims either :-) ).

    Keep blogging about the progress…

    Comment by Karl Fogel — May 26, 2007 @ 3:31 pm

  2. This is invaluable info Biella — I know a ton of people having problems with their health insurance. Maybe we can compile a list of state by state resources to help people out?

    Comment by Praveen Sinha — June 1, 2007 @ 3:29 pm

  3. [...] so long ago, I blogged about my trials and tribulations with Blue Cross Blue Shield of NJ. I got a very interesting [...]

    Pingback by Interprete » Michael Moore wants to hear your horror stories — June 8, 2007 @ 7:03 am

  4. [...] so long ago, I blogged about my trials and tribulations with Blue Cross Blue Shield of NJ. I got a very interesting [...]

    Pingback by » Blog Archive » Biella Coleman: Michael Moore wants to hear your horror stories — June 9, 2007 @ 1:43 am

  5. [...] few weeks ago, I posted an account of my trials and tribulations with Blue Cross Blue Shield Horizon of New Jersey. Well now it is [...]

    Pingback by Interprete » Blue Cross Blue Shield Chronicles: Blue Distinction, Not — June 11, 2007 @ 9:21 am

  6. [...] few weeks ago, my friend Biella posted an account on her blog of how BCBS Horizon of New Jersey (hereinafter “BCBS”) was denying a claim of hers on [...]

    Pingback by » Blog Archive » Embarrassment-based health care. — June 12, 2007 @ 9:05 am

  7. I am so frustrated with BCBSNJ. I have a $1000 max deductible that includes co-pays, co-insurance, and deductibles. I have been overpaying them since 3/31/09 until I was told by a coworker that I should not be paying over the $1000.00. So I sent letters to all my doctors and they reimbursed me the co-pays, but BCBS will not pay me for the overpayments I made in 2008 and 2009. It totals to about $1400.00. This does not even include yrs 2005-2007 The customer service employees, including the supervisor, all recognize this and have sent it to another dept., and the other dept keeps on saying that I have not reached my deductible! I have been calling since March and I do not now what to do next? can someone advise me…please..please !!!

    Comment by Char — October 16, 2009 @ 6:06 am

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