My 47-year-old husband was diagnosed with a very rare form of cancer in April 2016. After three opinions, it was clear my husband's only option for a cure was insanely strong oncology treatments, followed by a liver transplant, that is only offered at two locations in the United States.
Over our professional working lives, my husband and I have paid premiums to Blue Cross & Blue Shield in excess of $350,000, and have never had anything worse than broken ribs as a claim. Invested wisely with even the most modest return, those premiums should have netted Blue Cross millions.
To date, I have logged over 300 hours either securing approvals for evaluations and treatment, and then getting them to pay for what is clearly listed as covered benifits.
Not one single claim has been paid without being denied and appealed. We have been assigned our own appeals and greivances agent who routinely cannot even find the denied claims. When he looks up claims that are listed as not paid on BC&BS own patient portal, his screens tell him they have been paid.
When he tried to secure proof of payment he could not. In other words, even though his data base tells him certain claims are paid, in fact they have not been.
I could go on for many more pages detailing the institutional craziness I have discovered.