I just had a frustrating conversation with an employee of Anthem Blue Cross Blue Shield insurance company. I cannot believe what I was told.
Anthem has paid for only 7 out of a possible 12 yearly covered visits to a chiropractor. Yet, the insurance company will not cover further treatments for me this year, claiming that my yearly quota has maxed out.
This makes no sense, since they have only covered 7 out of 12. The reason for the discrepancy? I made several visits, paid out of my own pocket, to a chiropractor outside Anthem’s preferred provider list. So what? Since Anthem refuses to cover those expenses, I should be okay, right? Wrong!
Because I dared submit a claim, even though they didn’t pay a cent, Anthem Blue Cross counted them against my allowable benefits! Anthem penalized me for simply asking for their help and then being refused. How absurd! How blatantly unethical. Anthem Blue Cross Blue Shield has unethical business practices.
After telling the employee how wrong this policy was, she said she would not discuss the immorality of Anthem policies. I asked her if she enjoyed working for Anthem, and she answered she loved her job and would never leave it. She stated that if I had not submitted those claims, it wouldn’t have been a problem. I can’t believe she could say that to me with a straight face (I assume). Be quiet and you’ll be okay. That is the message.
Anthem is a shameful company. I’m sure that Anthem and other American Insurance Industry companies implement this bait and switch trick on thousands of unsuspecting customers who dutifully pay their insurance bills.
I hope it doesn’t happen anymore. There are really people that speak to others in unethical way. Talk to another employee, perhaps to the person’s immediate superior, to clear things out and of the undue customer treatment. Anthem will surely wouldn’t want such employee as well.
Wo wrote the reply from Blue Shield??? The grammar sounds like a 4 year old, or someone so unfamiliar with the English language that they should not be writing publicly at all!!!
@frisco: It’s funny, I didn’t think of that when the comment appeared. I’m sure there are lots of Latinos or non-English speakers working for Blue Shield. Perhaps this person is not normally a “public” figure, but wanted to leave a comment of support.
Unfortunately, the problem was not a rude employee, but the policy of Blue Shield, a much more egregious fault, and all the more reprehensible and disgusting.
it is unfortunate that they did not cover your visits. in my experience working with insurance companies i hear a lot of issues with insurance companies not paying for things. i guess fortunate thing is that specifically health insurance companies are strictly regulated by insurance commissioner. my argument would be is that health insurance coverage is designed to cover unexpected major medical events. just like car insurance does not cover your oil changes. i have coverage to cover only for unexpected major medical events