Saturday, January 27, 2007

You're in good hands with Allstate

Or as a pastor once said "Have too many accidents and Allstate is going to get you out of their hands". Which brings me to BC/BS of North Carolina. Seems that in order to keep our health insurance premiums the same for that little group of ten merry men I work with, Blue Cross made us an offer we couldn't refuse. Just raise your deductible from $500 to $5,400 and add $10 dollars more to your office co-pay and forget the free generic drugs and we will let you live. Being the smart physicians we are the group opted to create a MERP (Medical Expense Reimbursement Plan). The fellow who came to us with this proposition was one of the docs' friends. The guy reminded me of the "jump to conclusions" guy from "Office Space". However, after a half hour of explanation I began to see that we were really self-insuring the high deductible. Sort of laying off the risk like a bookie. Now the MERP plan required us to do a little more leg work. I had to fax in all my EOB's from BC/BS and my prescriptions, etc. Now our BC/BS card no longer listed any of the former benefits like co-pays and Rx. drugs. Instead it just had that $5,400 deductible printed on it in day-glo letters; which meant you better have your VISA card with you at all times. The name of the MERP company I can't divulge because of the ongoing investigations by the SEC, FBI and Justice Department. We asked for a card to put in our wallet so we didn't get harrassed for the co-pays. Our MERP company sent us cards that tried to explain the screwy plan in 250 words or less. This card (which looked like I made it on Photo-Shop) caused a myriad of dumb looks and confusion at all the Dr's offices and pharmacies. This new-deal plan coincided with CP's foray into the chiropractic nebula. About 3 days a week I was at the Fax machine working the MERP. All went well for a couple of months, but then the checks stopped. I had the sneaking suspicion that I was faxing to some machine located in a storage facility. Finally the truth came out: the MERP company had moved off shore. To the Cayman Islands; to be specific: GPS latitude 34 longitude 183. But it gets even better!

The hospital I am affiliated with and to whom my doctors works for will no longer accept BC/BS. It seems they say BC/BS is low balling them and the two are in a spitting contest. Besides not being able to go to the hospital I'm affiliated with, or see colleagues I know on a first name basis, this will also cut down my revenue if the BC/BS patients have to go to the next town along with me. I found this out as I was leaving work to go for my three month blood-pressure appointment. I'm driving the mile from the hospital to my affiliated doctor thinking I'm not going to pay $96 for a blood pressure check. I walk in and am trying to remain coherent. I asked the receptionist (who I lovingly refer to as the amoeba) if it is true that they no longer accept BC/BS. She says YES. She says "we really feel bad about it and there isn't anything we can do, I'm afraid we will be losing allot of patients". I calmly say "cancel my appointment, this means I have to find another doctor". By now I feel like blood is about to shoot out my right eye.

Everyone knows that rumors travel around a hospital quicker than the common cold. I come home and tell CP and she tells me there is a letter in the mail from the hospital concerning this. I don't care to look at it. Instead, I do what I usually do when I'm stressed out: I go to SAM'S CLUB. As I am walking in my cell goes off and it's my doctor telling me that the BC/BS thing doesn't take effect for six weeks. She tells me I need to keep my blood pressure under control and that hopefully this little feud with the insurance companies will be resolved in the next six weeks. I didn't feel like a total mug because her office staff didn't have the facts straight either. So I'm rescheduled for this Weds. Now for me to get out of work by 3:15 pm, the time of their last Monday through Thursday appointments, isn't easy so I really feel like a bone-head. Alas, don't worry, George Bush is going to fix health care with a tax deduction for 2 per cent of the population. But don't get me started on that. Somewhere in the Cayman Islands there is some insurance CEO drinking a Pina-Colada on my tab.


Anonymous said...

Excellent. This should be an op-ed piece. M-

Anonymous said...

We're in the wrong field of work. Lets form our own MED-IN-CO (Medical Insurance Company. We can collect the funds and move to Caribbean or South-Seas island and live off of the the other "lolly-pops".
I just got done feuding with both ITT Space Systems Division and Empire BC/BS to get these two to agree on paying a bill for Tom for services he had back in October.
While talking to a boss at Empire BC/BS the need for them to start paying an additional charge of 21% interest on top off the owed amount, this woman quieted right down and went into defence mode. Tom's bill is now paid.
Hang on to your seat it's only downhill from here. I understand that the Drs. offices are not getting paid now. What will it be once the Fed's screw everything up?
I do agree with Mary, put the rundown of the insurance debacle in the Asheville newspapers. Change the names to protect the innocent (you).


Aunt Dot said...

This post is hilarious while unnerving. Hilarious because of the very descriptive, picturesque remarks like "By now I feel like blood is going to shoot out of my right eye":-)!! Unnverving because being Blue Cross members, it could happen to us!! In fact, last week U.F. and I got a generic B.C. letter saying that our insurance will no longer be accepted at a hospital in Huntington Beach and La Palma or Anaheim, I think. I thought, no problem, (yet), because I wouldn't even think of going there. We live in South County and go to other hospitals that the doctors we go to have privileges at. (I know, don't end a sentence with a preposition). Hey, this is colloquial, okay?

Anyway, *it could happen to you*, right? It is just a matter of time.

Here's hoping that MERP company comes back from the Caymans, 'cause
that catastrophic insurance is like having nearly no ins. at all!!

Maybe you'll want to move to the big city and get on with a hospital that pulls in the cash so that they can afford insurance until you and Care-bare are ready for Medicare!!

Anonymous said...

Sounds like the same people run your church and your insurance.


Babba-Gi said...

O.K. I get it. My deductible going up $5000 was God's Will. I feel better now.

Marianne said...

Uh-oh! Should I sign back up for my crappy college insurance? At least that copay is only $35.