in...Shadysurance

Man, I'm usually not one to rant on here but BCBS has got me full-on hot! Ok, so I had a ton of tests done on my heart at Mayo- like last year. Every test that I had done was first ok'd by Mayo with my insurance before it was performed. Wait a second- let's first think about hospitals and doctors and the word "investgative." Now when you go to the doctor with a problem, don't they have to run "investigative" tests to figure out what in the hell is wrong with you? That is what I always thought. If the doctors knew exactly what was wrong with you as soon as you told them your symptoms then I'm sure they wouldn't need the millions of dollars worth of "investigative" equipment. Right?

Ok, so getting back on track here- BCBS denied a claim for an MRI on my heart and dismissed it as "investigative." This was after the Mayo had called to get it approved. At the time, BCBS said that that kind of test did not need approval. But a few weeks after the test the rules changed, it now needed approval but the BCBS rep assured me that the test would still be covered. That was BEFORE my written appeal just came back- DENIED! WTH? Not only did BCBS and their physician reviewer deem that test as "investigative," but they also went back and decided that another claim that they had PAID to Mayo should have been denied and now they want to go back and request a refund. Man, I always thought I had great insurance because they had always covered so much (even though the ridiculous deductible and co-pays go up annually)- but this is retarded. Not to mention that the MRI was the final test that confirmed the HCM diagnosis.

So now I have to formulate a game plan but I know it will start with a 2nd appeal. I always hear so much about insurance issues that people have, especially people with my heart disease once they start getting hardware bolted into their chest. Ironically, I just read yesterday about the top reasons for bankruptcy and the #1 cause was medical bills. Not that I have any crazy bills (yet) but I can see how nightmares can come from punk-a$$ insurance companies.

Well, now that that's over with- enjoy a slick shot of my roll dog plowing through her share of my Bluegrass Brewing Company American Pale Ale.

Cheers!