YOU CAN’T MAKE THIS STUFF UP

Greetings my thousands of weekly readers. OK, greetings Brenda, Tina, Patty, and my wife. Thank so much, blah blah blah. haha. You can actually SEE, FEEL, and HEAR my snarky-ness (did I invent that word?) Well since I am feeling snarkier than usual today, let me share a funny-not-so-funny ongoing battle that I am having with my beloved health insurance company: The MIGHTY ANTHEM BLUE CROSS BLUE SHIELD.

Let me begin by telling you that the people who work customer service, or “client helping assistants”, or “whatever they are calling this underpaid work,” are generally great. They are on the phone all day getting yelled at, so I try to be extra polite. Shocking I know…me polite. Hey, did I mention that I’m ramped up Snarky McSnarkyson today? The phone people…let’s call them TRENCH WORKERS since they are on the front line, are patient, polite and respectful. I have no problem with them. My problem lies in the bubbling cauldron of excrement that IS the private health care system. I am not going to rant about how they say no to most claims the first time, or how they deny tons of stuff that, in their words, is “NOT MEDICALLY NECESSARY,” as all of that has been covered by the internet. The internet never lies. In fact, I am reminded by the famous quote spoken by Abraham Lincoln: “Always check your internet sources.”

So, my primary care physician (PCP) retired on January 1 of this year. Time to pick a new doc. My old doc, who I have written about and love, warned me that the health care system is now a wide murky pile of steaming dung that traps patients in the quagmire. I thought he was exaggerating. He wasn’t.

For years I was spoiled as I always saw HIM. Now he’s gone and…..what is this intake by one person, another person does my vitals, and then a physician’s assistant comes in? It’s like an assembly line in there, and then they check a bunch of boxes while saying things like….Ok, you’re 50, you need so much vitamin D, you need the prostate exam, let’s check those skin moles, how are your eyes? whew. What happened to treating the person? I feel like a used car in there…..oh, it’s been 3,000 miles and you have 75,000 on the car? Oil, transmission flush, check the Johnson Rods, adjust the canooter snooter and only put blue air in the tires from now on…..did I mention my chronic illness? Yeah, the new docs aren’t all that concerned about it either….as soon as I told them I have other docs for that it was more about my overdue tetanus shot. Not too likely that I’ll be stepping on a nail, but there you go.

So here’s the fun part: Since January, I have called my insurance company (ANTHEM) 5 times to “select my new PCP.” Each time I call, they tell me the name of my doc that retired, and I say…no, this is a new one. Each call takes about 45 minutes as I am on hold and then informed that I have a bunch of open claims. I know this because ALL of the claims have been sitting unpaid because “NO PCP SELECTED BY MEMBER.” The trench worker then realizes that is why I’m calling, although I already clearly stated this to the nice ROBOT who asks for “A GOOD NUMBER TO REACH ME, SHOULD WE GET DISCONNECTED,” after stating that “THIS CALL MAY BE MONITORED FOR QUALITY AND TRAINING PURPOSES.” Seriously? They record the robot part of the call? I weep for the future.

So after all this waiting while listening to some scary piano music with minor chords that frighten my soul, the nice lady from the trenches tells me she “DOESN’T KNOW WHY THE SYSTEM WON’T TAKE MY NEW PCP NAME AND NUMBER, ALTHOUGH SHE SEES HIM LISTED AS ACCEPTING THE INSURANCE AND HAS HIS NPI NUMBER.” All of this has made me dizzy and I inquire as to what my co-pay is for emergency room visits. (kidding, I don’t ask that, because the TRENCH WORKERS do not understand humor….hmmm, I wonder if the robot does.)

She kindly tells me that she sees in her notes that I have called about this before. I agree. She tells me that she has someone higher up than her working on it, as she is also unable to back date the claims more than 30 days and I have some unpaid ones going back to February! I thank her, and also already know this since a few of the service providers have called me and asked me to call the insurance company as they want to be paid. Did I mention that my family insurance plan through ANTHEM is more than $26,000 per year for our family of 4? Mind you, much of that is covered by my wife’s school district, but there are also copays for everything AND any medical gear that I need is only covered at 80%. Fifty bucks in supplies for my sleep machine? No sweat. My $40,000 power wheelchair only covered at 80%? Do the math. So besides all of this, no one can seem to assign me to the new doctor that I’m seeing (well, his staff anyway) which has also screwed up some of my prescribed medicines. It’s all lovely. The private American health care system.

In closing, TRENCH LADY (very nice woman I might add) told me yesterday that this would all be resolved soon. I kindly asked her how she is sure, since everyone I’ve spoken with has said the same thing. She replied “Oh, well, the difference here is that I’m leaving this inquiry open, so it will be flagged until it gets fixed. I am not allowed to give you my email, phone extension or full name, but I will leave you a voicemail to let you know when this is all set.”

I’m sure that will do it. Leave the inquiry open. There’s the secret.

Your call is very important to us. Please continue to hold.

Stay safe, stay awesome, and stay tuned next week as I update this story. It shouldn’t be this hard.

PS: Anthem CEO Gail Boudreaux earned $19.3 million in total compensation for 2021. Her pay included a nearly $1.6 million base salary and $9.9 million in stock options for the year. Boudreaux also earned $3.3 million in option awards and $4 million in non-equity incentive plan compensation for 2021. The CEO pay ratio at Anthem was 379:1, with the median employee earning $51,005 in 2022. – Source, Forbes, and checked by Abraham Lincoln.