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Re: “Letters

This is a rebuttle to Timothy McGettigan's "Squeeze Play" letter. Mr. McGettigan's letter clearly illustrates that he doesn't know how health insurance claims are filed and who he should be able to contact for help. It sounds like he's on an HMO plan, which is typically copay-driven. But Anthem, like all insurance carriers, pays their claims based off the procedure codes the PROVIDER submits. So he should be contacting the provider to find out why two procedure codes were submitted for one MRI. If he did contact the provider and wasn't satisfied, then he should have enrolled the help of the broker who sold the policy, whether it was an individual policy or through his employer. It's part of a broker's job to service accounts and be their client's advocates. If Mr. McGettigan purchased an individual policy via the internet, thinking he'd get lower rates by cutting out a broker, then he got what he DIDN'T pay for-mass confusion and no one to help him. People who purchase coverage via the internet need to realize commissions are already built into the rates, so they really should have a professional assisting them so they can call on their experience in situations such as these. People who are insured through their employer should contact their HR department for their broker's contact information and get the broker involved in the dispute. People, please don't think purchasing individual insurance via the internet means it's easily understood or that you can handle any misconceptions, etc., as successfully as a licensed broker! "Sicko" is filled with scenarios very similar to these, scenarios that may have been easily rectified had the right professional been called to help. Mr. McGettigan, if you did try to work with the broker on this policy and received no help, please contact me. I'd love to take over a policy where the broker isn't doing their job. Sharlene K. Yabe Transcendent Benefit Consulting Colorado Springs

Posted by Springsinsconsultant on 10/23/2007 at 5:00 PM

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