Jaxman187

Is anybody else having problems with our new provider? This blue cross insurance is driving me crazy. I've got an infant with neurological complications since birth involving excessive fluid on the brain with significant effects and Blue Cross is turning down every claim. Our in-network Primary Care Physician made the referral to the out of network pediatric neurologist(only 1 for 75 miles). Yet they continously reject payment of the neurology visits and requisite MRI's. We get approvals and apologies over the phone from the Blue Cross admin people but they never pay. It is driving my wife crazy. These bills just keep coming and coming for the same charge while I am away on trips. I don't know how many bills my wife has paid that she should not have.

Also, they are rejecting her routine personal appontments for no reason with in network MD's. They claim that it is because they need to find out if she has another primary insurance policy. She doesn't because she does not work, but if she did wouldn't it be up to her to choose which insurance she uses as the primary.

No messages of support are necessary, we think the kid will be just fine in the long run. I just want to know if I am the only one having these kinds of problems. I am burning up way too many man hours tying to get BS insurance issues resolved?

I remember hearing how good this policy is, but if I have to fight for every little benefit is it really worth it?

jrNWACA

Keep a notebook with all dates and who you talked to. My wife has that policy for my stepkids and I also have BCBS. If you did have two policies, you do not get to pick which one is first. It is based on date of birth of the policy holder. But, that does not mean that there cannot be a primary and secondary insurance.
They should be paying in network since there is no one close by. BCBS is just trying to hang onto their money. Check out www.theinsurancewarrior.com and talk to the HR person. They should have a BCBS rep assigned to the corporate account. Good luck.

Maria80386

Sometimes you need to involve your State's Bureau of Insurance to get things resolved. It's amazing how fast the insurance company gets their act together when a state investigator is breathing down their neck.

MaydayMark

My wife has had her last several claims not paid for the same "other insurance" question. She's disabled and does have other insurance (Medicare) but it pays secondary to any FedEx insurance by law?

On a different but related subject, I'm also having major issues getting my copays and deductibles paid by my Flexible Spending Account. They keep getting kicked back to me (interestingly, not the provider) saying they need additional info. This even happens occasionally with the (FedEx) mail-in prescription program? Anyone else having this problem?

Jumbo Pilot

I know and understand your frustration with the "Insurance Establishment".

But I have been more pleased with BCBS since the switch. But I had a very bad experience with the wife's healthcare and claims and billing with Cigna 2 years ago.

Like most things it's all a matter of how much pain each one causes us.

Good Luck with fighting "The Establishment"

seefive

Haven't used medical too much this year but my son went to the ER and i was told my copay was 150. I told them my old one was 100 and that i believed the new copay was lower. I paid $100 on the spot. Went home and found my copay should have been $75. I called BCBS and they said wait til i got a statement of benefits. Got that and BCBS still said i had a $150 copay. I called again and they said "yes, it should have been $75". They refiled the claim and paid the difference and the hospital automatically sent me a $25 check. The whole thing was BS though. Watch the small stuff.

FlybyKnite

They were denying claims for my wife's appts too. The Doc's office mentioned that there were several outstanding insurance bills. She called to chew them out about non-payment and that was the first time we heard about the "other insurance" question. They said "We mailed a letter"-- nope, never got it; no other insurance; now please pay the bills.

MD11Fr8Dog

My wife had a couple of surgeries in the spring with all the pre and post op appointments. Had a some denied coverages, but eventually got them all paid with a few phone calls to BCBS. Kind of a pain, but we got it all taken care of!

KnightFlyer

Same here with wife's cancer surgery and post-surgery tests, exams, etc. Everything's been paid, but keep getting the "other insurance" paperwork. My wife sent them a stern letter about the 3 separate ones we got in a week and things seem to be better now. Anyone talk to FDX ALPA R&I?

fedupbusdriver

The only problem that I have experienced is refilling a prescription early. Flying international, sometimes you must fill a script a few weeks early, due to the fact that when it runs out, you will be out of the country. A phone call fixes it, but if it happens again, I will be calling the union.