"Slow Pay, Low Pay or No Pay": Blue Cross Approved Surgeries Then Refused to Pay

I've called my insurance company to check whether they'll cover certain medical procedures. And they'll actually play a recording before transferring your call - something like "Statements of coverage during this call are estimates, and are not actual guarantees of payment."

I also learned that they have a whole bureaucracy already in place for appealing of payments. (People whose job it is to field all the rejected and then appealed claims, and write multi-page letters explaining their reasoning...) So I took my complaint to my state's consumer complaints department. Let the two bureaucrats explain things to each other.

And in the end, the insurance company paid me.

Also happened to an in-law of mine. After they got pre-approved fall bladder surgery, the insurer came back and said the surgery was "elective". They paid after a fight.

Having to fight to get payment for anything major has been more common than not, in my immediate family's experience and from what I've heard from friends and relatives, for a long time.

The tens or even hundreds of hours on hold with insurance providers and hospital billing departments and calling state regulatory agencies and time sorting through the fifty bills scattered over ten months from nine different entities, all for a couple days in the hospital, are a massive unaccounted-for cost of our already-record-settingly-expensive healthcare system.

> So I took my complaint to my state's consumer complaints department. Let the two bureaucrats explain things to each other.

Except that the prevailing direction of the country is to destroy the ability of governments to function effectively. It seems like a well planned move to actively destroy the only entity capable of standing up to big business.