My first big girl job after graduating from college, I worked for Blue Cross/Blue Shield of Illinois. I started out on the phones answering questions about Medicare. Then I transferred to the Health Claims department where I enrolled in the management trainee program to become a Claims Supervisor. I worked there for close to nine years. I then went to work for ASA, who designed software for Health Insurance companies such as Cigna, and other state Blue Cross/Blue Shields. Ergo, I know health insurance. I have become the family ‘go to’ person if there is a problem with a doctor’s bill, hospital bill or insurance problem.
I also was the Power of Attorney for five years over my parents’ estate. I handled all of their medical and hospital claims until their death. My father had dementia and my mother suffered severe depression. Their medical bills were astronomical and I certainly learned a lot.
My frustration lies with the FSA, or Flexible Spending account that we currently have via my husband’s company. Our claims are mostly for prescription drugs; my husband has a check up twice a year and mine is only once a year. I submitted a claim for his five prescription drugs and my two. I filled out the claim form, signed it and submitted it for processing. When they mailed us the check, they covered my husband’s but not mine, saying that there wasn’t enough information. What? Granted they had a copy of the bill since I had faxed it; the receipt had my name, date of birth, the name of the doctor, the name of the medication and the cost. Really? Reading the documentation, I had to appeal this decision in writing. So I did, but this time I sent it via snail mail and sent the original receipts from CVS.
Friday, I got another denial, saying the information on my drugs was incomplete and it was a duplicate. I am SO irritated I could scream. At least they indicated I could call them which I will do once I calm down. I know for a fact that the processors are only paid minimum wage, so that may explain a lot of this confusion…..