Thanks to the grand blue plan, I have discovered that I have a friend: the North Carolina Department of Insurance.
The saga started 3 years ago when my twins were born via C-section. The anesthesiologists at my local hospital, which was on the “Blue approved” list, had banned together and decided that they would no longer be included “in the network.” Luckily for me, I had out of network coverage as well, so even when the doctor’s office sent a letter and $1000 bill, I figured I was okay.
Fast forward to over a year, and least 6 attempts to file, and about 12 phone calls to the blue plan later. The blue plan evidently has decided that it won’t pay bills to out of network doctors, so they just kept rejecting the claims (alternating reasons of wrong claim code and invalid dosing code.) At this point they are also routinely rejecting claims from my out of network bloodwork lab and an out of network pathologist.
Enter MY HERO: NC DOI. I read about them in a article about consumer complaints against the blue plan. They have a handy-dandy online complaint form, and within just 2 weeks of sending in all of my supporting rejection notices, the blue plan coughed up the money. Of course, they weasled by saying that it was their Pennsylvania office (total untruth), but at least they finally paid up.
I’m about to contact NC DOI again about the blue plans systematic bungling of ALL of my claims from last year.
I LOVE YOU NC DOI!
Tags: blue cross, horror stories