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Post by zabrubon on Feb 22, 2010 2:00:26 GMT -5
Hello all, I just got a new job and the boss offered me health insurance at $5,000 a year or the money in my pocket. Well i chose the health insurance. I applied BCBS of Illinois and they denied me cause I had counseling in 2003 -2005. I did not tell them exactly why(morgellons) but I did tell them there was a personal family matter. (which was true) I never had any medication or anything. They denied me, they say because of the counseling.
I think the real reason for the denial was because when I filled out the application, I forgot to sign on one of the lines. So, they called me. I gave them my office fax number and I told them only fax if you call me first so I can stand there and get it. I did not want everyone in the office to read my personal information. Blue Cross then faxed it a week later WITHOUT calling me. There my personal information sat for the world to read. Was I embarrassed and mad. I called and talked to supervisor. She said sorry. I told her sorry was not good enough. I said there was a Hippa Law and they violated it. I told them I was going to call Bill O Riely and Glen Beck and tell them. Hahahahaha. I guess they did not like that. So anyway, now I have a denial letter. I have contacted Hippa and downloaded their complaint sheet. But what else to do? Can Blue Cross really do this to me? Can they really deny me for counseling? They had asked me if I was healed. I told them I wasn't broken so how can I be healed. Hahahaha. They fixed me good didn't they. I will appeal it though. But what to say. How to defend myself? Yeah, that's the question. ChicagoBonnie
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Post by friskers on Feb 22, 2010 2:32:43 GMT -5
Hi Bonnie Im so sorry that happened to you. I dont know if they can deny you legally for that or not but it sure does not sound right . They may be able to deny future counciling on the grounds that ita a pre existing condition or something like that but I wouldnt think they could apply that to medical treatment too. Sounds fishy to me! What is the hippa law anyway? Im not a fan of blue cross even though I had them for prob 20 years ,they are always changing their policies and denying treatments and yet raising there costs but it wouldnt surprize me if they are all like that! I wish you the best of luck! Friskers
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Post by freaky on Feb 22, 2010 4:09:31 GMT -5
Oh Friskers, you silly girl. (just kidding)The hippa law is the one that gives the patients their rights, like the dr's. office can't leave a message with anyone, or talk on the phone about you with someone else. They can only talk to you.
Hi, CB. No, they can't do what they're trying to do. Everything they do is based on the fact they don't want people to get drugs because they make more money if they can keep you from getting them. (long story) I don't know how many times I've had to appeal because they wouldn't let me have my prescriptions. Also, I had counseling. Most people don't even know about the appeal option, & don't give them any flack. You just call back tomorrow, ask them who you appeal to, find out who you're speaking to, & get the address where to mail your letter to. I don't know, you maybe can fax, or e-mail your letter. I'll PM my phone # to you, so if you have any questions, call me, & I'll find out from Mr. Bill. Not to worry Sweetie. they're just harassing you. Maybe you should call us first, if you can wait until after 10:00.
Been missing you. We've had BC for years.
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Post by mercury on Feb 22, 2010 7:04:01 GMT -5
Bonnie, I'm very sorry you're having to deal with this crap from the insurance company. I've used to own a small business until I got Morg's. My understanding is that most group health insurance plans are required to accept all members in the group without regard for preexisting conditions. I don't know what kind of plan your boss is offering you, but if it's a group plan that his business offers then I think you shouldn't be excluded for preexisting conditions. Does your boss offer just the Blue Cross Blue Shield plan or does he offer other plans as well? If your boss does offer other plans, those plans may not consider preexisting conditions.
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Post by ctbarb on Feb 22, 2010 13:07:58 GMT -5
Bonnie, The new Obama health program states that pre-existing conditions cannot be held against anyone. Even though that's not in existence yet, BCBS has violated your privacy by sending that information across the fax! It IS a violation of the Hippa Act! Furthermore, you should be on the phone NOW calling the Illinois State Insurance Commissioner and filing a complaint. Your employer cannot ask you about your previous health conditions or present ones either...only as it affects your job performance. Tell BCBS that you will institute a lawsuit for violating your privacy under a Federal Act. Bet you have reinstated coverage by the end of the day! Good luck! Another case was just solved recently when I found that my best friend was still paying for her dead husband's first deceased wife and for him too (he passed last year). BCBS sent her to Collection for non-payment of the bill! She was so upset and didn't know what to do! I called the State Insurance Commissioner's office and asked them if it was their practice to insure dead people? They said "Of course not!" Long story short, she is being taken out of Collection, and is getting a refund for ALL payments made for the dead ex-wife, and her now dead husband! All it took was a phone call, and faxed Death Certificates. Done deal!!! They will get away with anything they can...if you don't question it and tell them legal action will be taken, they will continue to get away with it. Make them accountable! They have violated YOUR rights now...you gave them instructions, they did not follow them. Their problem, not yours. If they do not respond in a timely manner, take the matter up with the person in your company who is responsible for the medical insurance coverage and don't take no for an answer! Insurance companies make billions of dollars on folks who do not take them to task. Don't be one of them! Love and prayers, ctbarb
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Post by rhorn2006 on Feb 22, 2010 15:15:45 GMT -5
Bonnie,, I am so sorry to hear this,, it's not at all fair!! I hope it all works out for you though..
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Post by bannanny on Feb 22, 2010 17:25:50 GMT -5
Yeah... sounds a little like they're just trying to overload you with their games. Like barb says... don't let them do it! If you do, they will!
Good luck sweetie...
hugs ~~ bannanny
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Post by zabrubon on Feb 22, 2010 22:52:20 GMT -5
Frisk, Freaky, Mercury, Barb, Rhorn, Nannas,
I knew you all would help me. Thanks so much for the knowledge and the support. I am loved and that feels good. My employer insures no one else in the company except me. And only because I said I needed insurance. They offered me salary of XXX and I could take that and no insurance or I could take insurance and have that deducted from XXXX. The only thing they really helps is uncle sam can not tax the five thousand dollars for health insurance. The funny thing is, when bCBS denied me, I had to return the nine hundred and twenty dollars to the boss. That was $450. each month that should have went in my pocket. Right? Don't you think they should pay me that $450.00 for two months of noncoverage? And March too, if I still have not coverage. Ahhhhhhhhhh, the whole world has gone mad. I feel like I have to constantly fight and argue with everyone. I am very tired. Very tired.
HIPPPPPPPAAAAAAAAAAAAAAAA, I have already downloaded a HIPPA form toreport BCBS. That nasty little underwriter deserves it. She has caused me embarrassment, and stressed me out. I talked to the doctors office today (had to cancel my appt) and the nurse said that five years has passed since my counseling and they can not claim the "preexisting" condition. She said to use that in my appeal. I really need the insurance, my doctors visit is three hundred dollars. Back to BCBS, I am going to get them good. I am not going to allow this to happen. That underwriter needs to be fired. She should stand in the unemployement line for a while and think about what shes doing. Let someone else who appreciates a job, fill her position.
Illinois State Insurance Commissioner here I come to complain. Thanks CTbarb.
Thanks all, and Frisk, I will call you, this weekend. Going to bed now. Night all, and I love you all lots. ChicagoBonnie
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Post by friskers on Feb 22, 2010 23:36:10 GMT -5
Oh what a mess Bonnie but i know you and you will get it straightened out!! Remember when they denied you unemployment? And you got it ! Im sorry you have to deal with all this stress! Yes I think that money should go in your pocket .........unless they plan on using it for another insurance plan .......but I have a feeling you will get blur cross after you make a few complaints they will be kissing your butt and telling you how sorry they are ;D
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Post by zabrubon on Feb 23, 2010 0:25:34 GMT -5
Friskers, ooh ooh ooh, i just filed a complaint with Illinois State Insurance Commissioner. Hee Hee. We shall see what will happen. I will be filing the appeal tomorrow night. I will send it with return receipt requested. That way they can not say they never got it. The problem is, it is a PO Box. I need the real address to Blue Cross. I have to look. CB
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Post by ctbarb on Feb 23, 2010 8:10:44 GMT -5
YAAAAY! Bonnie, good work! What do you mean they only have a PO Box? Someone still has to sign the Return Receipt. Get them while you still can...the longer you wait, the less they think you care...get on them and STAY on them! They kept my friend on hold for 90 minutes one day, and were surprised when she was still there! That's what they bank on...you'll get mad and just walk away, and leave the money in their pocket...not this time! Good work, Bonnie! We're all rooting for ya! Love and prayers, ctbarb
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vasue
Junior Member
Posts: 63
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Post by vasue on Feb 23, 2010 8:22:45 GMT -5
CB, send it Certified Mail & check the "return receipt" on the back of the certified mail card that you attach to the outside of the letter. The person at the post office counter can show you how to fill it out.
I've been sending tax returns that way for years to PO Box addresses.
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Post by zabrubon on Feb 23, 2010 18:37:55 GMT -5
CTBarb, I don't usually give up easy. I am a fighter. I sure hope I can squeeze them good. I will do my part and then, the good Lord will step up to the plate and hit a home run.
Vasue, thanks for the tip. I was under the impression it had to be a areal address in order to send it certified. You bet, I am going to check the box.Thanks for the good tip.
ChicagoBonnie
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Post by rhorn2006 on Feb 23, 2010 18:48:35 GMT -5
CTBarb, I don't usually give up easy. I am a fighter. I sure hope I can squeeze them good. I will do my part and then, the good Lord will step up to the plate and hit a home run. Vasue, thanks for the tip. I was under the impression it had to be a areal address in order to send it certified. You bet, I am going to check the box.Thanks for the good tip. ChicagoBonnie CB,,,, You can send a certified letter to a "P.O. BOX" just like you can to a normal street address.. Who ever pics up the mail for there P.O. Box has to singe for any certified mail in there box, in order to pick it up.... just like they would have to do at a street address... Once the BC/BS employee, who's duty it is to pick up the mail from there PO Box "has signed for any certified mail" it is legally considered to have been "hand delivered" to the person or business listed on the envelope!! BC/BS cannot claim "they did not get your certified letter" because it was sent to there PO Box, if there representative has signed for it and picked it up.. That's a fact of court room law!! Actually,,, any attorney will tell you that it is better to send "certified mail" to a company's PO Box, than it is to send it directly to there office address,, because the employee who picks up the mail at the post office "does not know who has sent the mail before signing for it" nor do they know who to refuse mail from!! There job is to pick up the mail and sign for what ever needs a signature to pick up.. Sometimes, when you send certified mail directly to someones office "and they recognize the senders name",, if they don't want the mail because it may lead to court room trouble,, they will often just refuse to sign for it!! In that case it is returned to you "unopened" and you cant say "they got my letter" in court.. Go ahead and send it "certified" to there PO Box!! ;D
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Post by bannanny on Feb 23, 2010 19:29:24 GMT -5
You got it goin on girl! You're gonna be ok!
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Post by zabrubon on Feb 23, 2010 23:10:48 GMT -5
Rhorn and Nannys thanks to you for helpin me gettiton to the giant BSBS. I love you guys. Your the best. Fact this board is the best. It feels so good to know we help each other out so many times. When I have issues in life, I think about you all here and I know someone or all here will help. Ahhhhhhhhh! my morg family. So nice and you give me a warm feeling in my heart. Thanks for caring. CERTIFIED LETTER IS AS GOOD AS IN THE MAIL BY FRIDAY. YEP! YEP! YEP! LOVIN IT.
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Post by rhorn2006 on Feb 24, 2010 1:37:38 GMT -5
To borrow from Sparky's lead,,,,,,,,,,,,,,, "YOU GO GIRL!!"
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Post by zabrubon on Feb 25, 2010 2:15:13 GMT -5
No victim mentality here.
Sent in my appeal for school because they had denied me, and I got a email today that I was approved. That's one down and three to go. Next is the insurance. Wheeeeee, this is fun. CB
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Post by bannanny on Feb 25, 2010 18:12:13 GMT -5
Thanks bonnie! You're my strength too and yeah... we are the best family ever here!
So you're GOIN girl!
It's all gonna work out... how can it not when people here like rhorn, barb, vasue, and even our silly freakerdeeks can tell you exactly what you need to do!
love ya ~~ bannanny
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Post by zabrubon on Feb 26, 2010 22:48:16 GMT -5
Bannanny, you are such a riot. Thanks for the compliment. Lovin you all and praying for us all continually. God hears our prayers.
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