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Rant About My Health Insurance: Moneycents Personal Finance Blog
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Rant About My Health Insurance

October 27th, 2006 at 05:21 pm

I have MDNY health insurance and I have had this particuliar insurance for the past 12 years. I have never had a problem with it, until today. I had a mamography last month and about a week later I got a phone call stating that I would need to have a sonogram and possible fine needle aspiration as they saw something on the mamography. Not to worry that it didn't appear to be a lump or a mass just something that they felt needed further evaluatiuon. They told me at that time to get a physicians order for the procedure and to set up an appointment. I set up my appointment for the soonest one they had, which happened to be a month away. I called the doctor and received my order in the mail on October 11th. Today I went to the Breast Center and I had to go to the cashier first. I presented him with my physicians order form and my insurance card. He preceeded to tell me that the order was still pending for the sonogram that my insurance company had still not approved it and for the biopsy he had nothing in the system with regards to that. So, I asked him well what should I do. I took the day off of work to have this done. I waited a month for this appointment. His response was for me to get another appointment at a later date and to get in contact with my insurance company,period... the end. I tell you, I walked out of there fuming. So, when I got to work I called the insurance company and they said it wasn't their fault, they out source their work to another company called Core Care National and it was up to them to approve my test. Okay, so I call Core Care and they tell me that they didn't receive the requisition for the procedure until this past Wednesday and that it was pending approval. They tell me that the blame lies with my physicians office for not calling in the request. So then I asked them "so what about the fine needle biopsy, who is supposed to approve that?" They say "oh your insurance company, MDNY" At this point I'm ABOUT TO SPIT FIRE through the phone. I call MDNY back and tell them the story again and they say "they won't approved a possible procedure, so the doctor will have to call the insurance company when they know that they are going to do the procedure." So I asked her "So I'll be lying on the table for days waiting for your company to approve the procedure????" "I told her that this was ridiculous and that I have been through these procedures twice before and have never had this problem in the past. I asked her for her supervisors name, number and address. She said that she would give her supervisor the message that I wanted a phone call back regarding this matter. Finally I did call my doctors office and spoke to the office manager and voiced my complaint and she told me that she would look into what had happened and that because she was going to lunch she wouldn't be able to get back to me until Monday. I GIVE UP! No words can express the frustration that I feel right now. I am so worried that if something critical were to happen to me or one of my family members that we would be up The Brown Creek. We are up to date on all the insurance premiums in fact they raised our rate in October and we paid the increase. I am going to start looking into other insurances. In the mean time, I hope that this was just an isolated incident(I have a feeling that it isn't the case). Is anyone else having problems like this with their insurance companies?

2 Responses to “Rant About My Health Insurance”

  1. yummy64 Says:

    I work for an insurance company. NOT THAT ONE though.

    To create the most internal fuss about this the best thing is to write to them or email them. But not customer service (obviously their customer service stinks) but to find some nice snr VP person(s) and write and tell them what happened. When this happens here the high ups go APE. Coping your state medical comissioner (or like) is a nice touch too. If the plan is through your employer copying them is a wonderful touch too.

    I'd still be looking for a company that insures people and has much better service "the we contract out so its not our fault" should be grounds for firing that customer service person.

  2. Thrifty Ray Says:

    wow- I am so sorry. It is not bad enough that you are in the middle of a test that could affect your LIFE...but you have the battle of the finger pointing between all the forces that be as well...The 'system' is definately broken when health issues are left in limbo like this.

    I was called yesterday and told that a nerve test on my arm would not be performed unless I paid $250 upfront because they were told my deductible had not yet been met...which it has...but now I get to argue with the insurance as well...

    My heart goes out to you. It doesnt sound like anything you can do today---but from here on out, I would ONLY talk to managers---ridiculous!

    Most importantly, my good thoughts are with you for good results on that test.

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