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It's a Banner Day.....


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Well folks what can I say, I'm not able to refill my targeted therapy this month because Anthem strikes again.  I've been disenrolled for a FIFTH time since September 1st.   Not able to obtain a new pair of eyeglasses either at this point.  I've filed yet another complaint with my former employer and this time with the State Department of Insurance. 

Unbelievable.   

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Michelle,

I’m not sure what the State department of Insurance does, sounds Important, but I went to our Attorney General’s Office!  It was a year long bill that had a coding error between the Clinic and Insurance and they corrected it within 10 days and wiped it off my bill.  Wished I would have gone that route much sooner.  Good luck to you,

Babs

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Thank goodness you're in top of this, still crazy and what if you were very ill and not well enough to deal with this nonsense.   Grrrrr!   

Insurance really sucks at times, but it's so vital in our care.  This BS needs to end....🤬

Huge Pet Peeve for me.... I'm really sorry Michelle and glad you're fighting this in every way....

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Well it’s another day, there was an emergency override placed in the eligibility system by my former employer (which takes 24hours to update).  
 

The targeted therapy will be shipped overnight (on their dime), so at least there’s a temporary fix in place.  

Some of you guys know I spent nearly 30 years in the healthcare industry.  One of my “bridge jobs” was for a Business Process Outsourcing tech company that managed eligibility and claims platforms for the largest health insurance companies.   I was flabbergasted to learn all of these “platforms” are vintage circa 1980s!!!  It was a crazy place to work and I lasted a whopping seven months!   It really comes as no surprise my COBRA is screwed up on a now weekly basis. 
 

Next week I hope to avoid all this drama since I’ve got scans.....

Thanks guys!  Carry on.  

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Good grief Michelle, you and insurance is like me and inanimate injury-causing objects. Glad it’s fixed for now, but I’d talk to your lawyer about how to prevent this. I know you had a settlement—was that filled with the court? If so you could probably move to hold them in contempt. If not, your lawyer could threaten to take them back to court to enforce it. That would cost them time/trouble and possibly put them on the hook for your attorneys fees. 

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I don’t think I’m going to need a lawyer this time, yesterday I got so fed up with this (not so) merry go round a Department of Insurance Complaint was filed. I fully understand they have no jurisdiction but I felt like I had to do something.   
 

HA.  I just got a call from the Department of Labor!   The KS DOI was so concerned about a Stage IV lung cancer patient not being able to obtain meds they filed a federal complaint on my behalf.  
 

My former employer is in violation of the Federal COBRA laws!!  The DOL is opening an investigation and assured me they will resolve this issue (plus the employer will probably get a decent fine to boot).  
 

Stay tuned!!!

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Let's hear it for gov't lawyers! Most of them are the good guys. 

Michelle, I'll have to tell you sometime about an interesting KS case I worked on over several months (most of the heavy lifting done by the people I was helping). It's really not on topic here, but it was a seemingly hopeless situation that finally turned out right for the young sexual assault victim who couldn't get the local prosecutor to take her case. 

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Way to GO Michelle!!!!  (Clapping my hands very loudly)!!

I truly HOPE this is a step in the right direction for ALL of us who have battled with the BS these insurers add to our lives.    This is not something ANY cancer patient should have to be dealing with -- especially a medication problem.  They should have "hand delivered" it to you in white gloves!

We will ALL stay tuned  and we all MUST continue to stand up for what is right -- especially our health!! 

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The issue here doesn't seem to be with the insurance company, but rather with Michelle's former employer who is not holding up their end of the deal to make sure her coverage is continued.

Yeah, the insurance companies have their own problems/issues in terms of how they treat their members and cover (or don't cover, or cause delays in or create obstacles to) necessary treatments, but this one I think is on the employer.

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We’ll see what the DOL investigation turns up- right now it’s an equal opportunity blame game for all involved parties.   Now that the Feds are involved the finger pointing has begun!  My guess is that every company has a contributing role.  

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Michelle,

This is crazy! So smart of you to take charge and go after your former employer!

There's no reason you should be put through this and I'm so sorry you have to deal with it on top of everything else.

Hope it's all resolved soon!

Best,

Ro

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Ii am so glad this has worked out for you but all the added stress must be just awful. I told my partner yesterday that I am so glad to be dealing with this here in Sweden rather than back in the USA. None of these problems with the medical system here. It truly needs to change in the USA.

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Michelle,

OMG!!!  I just read this from the top and it's bad enough that this happens once to somebody, but FIVE TIMES!?!  This is beyond the normal, "our systems seemed to have a problem", to just plain outright algorithms kicking in to get rid of accounts costing them too much.  I hope this all get straightened out and that there is no "Sixth Time". 

You deserve better than that.

Lou

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