During a recent visit with my cardiologist, she recommended I have an echocardiogram to see how my heart is functioning.
For those of you who aren't aware, I have been living with congestive heart failure since 1999. Although I believe my health has improved with a change in diet, medication and exercise, an echocardiogram is necessary to make sure. An echocardiogram uses sound waves to produce images of your heart. This commonly used test allows your doctor to see how your heart is beating and pumping blood. Your doctor can use the images from an echocardiogram to identify various abnormalities in the heart muscle and valves.
Now one would think an insurance company would be delighted to have a patient undergo such a test because good results can mean LESS DEPENDENCE on the company. But NOOOOOOOOOOOOO---my insurance company, Anthem, has denied the test. First, they said it was denied because the request did not come from my primary care physician, which makes no sense to me since she does not treat me for heart disease. But then, after my primary doctor sent over my medical records, I was denied again because the company said I was the one who had to give permission for any records to be released.
I think I can understand the need for the insurance company to see my medical records to make sure they're not being ripped off by paying thousands of dollars for an unnecessary test but requiring my signature to have them released is RIDICULOUS. Call me on the phone and ask my permission. Instead, they sent some paperwork for me to complete to give them a medical history---which is making me duplicate a job already done by both of my doctors.
I'm of the opinion that Anthem Insurance doesn't give a damn about whether I get better or not, which doesn't make any sense because the longer I go without that echocardiogram means I will be sucking them dry with medical expenses.
Perhaps this is an insurance company's way of killing off the baby boomers.
5 comments:
First, I am sorry to hear about your medical condition and situation.
It won't help your situation to hear that this is pretty common among insurance companies.
There was a movie starring Danny DeVito several years ago, in which, during the lawsuit against the insurance company, they had to admit that their 1st, 2nd, 3d etc way of dealing with a claim was to deny it and hope that the insured would just give up or die.....
I was sent to the emergency room by an ER crew, spent 6 hours while the medical personnel tried to diagnose the problem, numerous tests, etc- got denied by my insurance company even though ER is fully covered under my policy. I had the hospital give me (they wanted to charge about $75 for my medical records) my medical records- I filed a formal complaint with the insurance company and had the attending physician send in a detailed letter stating that it was a medical necessity for me to have gone to the ER- anyway, I mounted a full-blown attack against their denial and they did cave in and pay for the coverage. And this was BCBS- a major insurer that pulled this kind of nonsense! Insurance companies hope you will fold up and crawl away- just keep paying the premiums....
Insurance companies are regulated in every state- contact the insurance licensing bureau in your state.
Somewhere along the line, insurance companies forgot that the reason why we take out insurance is to be able to cope when things go wrong. However, insurance companies think it is about money - their money, Like hold on - how did they get their money in the first place? Right they bought assets with our payments and by finding ways of not paying out.
Good luck with your heart, I think its why I hate doctors and hospitals and am glad that I live outside of the USA.
Oh and the insurance companies are only one way of killing off the boomers.
I think we need to remember how we changed the world years ago and take back the world.
Hi Roberta,
Your comments made me smile. I think it's always been one big scam. The pharmaceutical companies in bed with the insurance companies and the doctors---keeping poor patients drugged up so they will have to keep relying on them--while the insurance companies keep taking our hard earned money and denying us coverage.
Thanks for stopping by and commenting on my blog.
Anonymous,
Sorry you had to go through all of that. I believe Anthem is a spin off of BCBS, which may explain why they are the way they are in light of what you've said.
Thanks for commenting.
It is not an easy situation to be in. You need the EKG and they decide it isn't what you need. I agree that contesting their decision is what you should do. People contest all the time, and some times they succeed (and sometimes you don't).
There is at least one third-party company you can turn to for assistance with contesting insurance denials. Called Kare360, they are an affordable means to sorting out healthcare and health insurance company issues.
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