Wednesday, May 20, 2009

Hey Regence: you suck!

Remember this awkward-looking ankle brace that I came home with a few months ago?


Like my cool purple cast and my Storm Trooper boot, it was provided to me by the doctors and nurses at Harborview’s Foot and Ankle Clinic. Apparently it would stabilize my ankle as I weaned off the Storm Trooper boot. Did I stop my health care team as they handed the brace to me, indicating its necessity, and ask to call my insurance company to make sure it was covered?

No, I did not.

As the nurse at Harborview Medical Center explained to me how to lace up my new brace, did I excuse myself to investigate whether the brace would be considered an “over-the-counter item or service,” which Regence healthcare plan expressly does not cover?

No, I did not.

See, I assume that when I’m in the hospital, being cared for by the medical team that has seen me through my entire ordeal, from the surgery to the rehabilitation, I don’t need to worry about my insurance company dictating what my doctors and nurses can and can’t provide for me as they aid in my recovery.

Hell, Regence covered my knee walker, my crutches, my Storm Trooper boot… and even the silly shampoo cap in the hospital, so why did they decide not to cover this brace?



I appealed their decision, giving all these arguments for why I believe that my brace (which, by the way, I wore maybe twice) should have been covered. Today I received a letter from Regence stating that the original claim processing will stand because the brace is considered an over-the-counter item -- even though it was provided to me by medical doctors and nurses -- and (get this!) “no calls were received prior to services being rendered to verify benefits.”

Really? I’m supposed to interrupt my doctors at every turn, every time they provide me with an item or service to aid in my recovery, to go call Regence and verify coverage? I should have called my insurance company when the cast was removed and I was given the boot? I should have called Regence when I needed crutches to walk?



I will appeal this decision too, and escalate my appeal to a corporate review board, because this is ridiculous!

Poopy on you, Regence! Just poopy on you. Today I think you SUCK.

KatFeb14and152008 117crop

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Anonymous said...

So, how much did it cost?

Margaret said...

I have Regence too and pay $600 a month out of pocket to insure my family, so anything they DON'T cover makes me go ballistic. I'm with you on this!!

loren2h said...

Don't even get me started!

Rositta said...

Well all I can say is that yes, it sucks but I'm going to have to pay for both casts and boots that I will need after my foot surgery. Our "free" health care system doesn't cover it. Also, in January I went blind in one eye. I needed a special dye scan so the retinal surgeon could see the damage before deciding if he could operate. It was done in a hospital and I was shocked when I was handed a bill for $150.00. Not covered by the government plan. So what happens to people who can't afford it, I asked. Guess they just stay blind. Oh yes, in our hospitals you bring your own soap, lotion, kleenex etc. and the rooms are old and decrepit. It's nota third world country, it's Canada...ciao

Lorrene said...

I just had knee surgery that was supposed to be in and out, but there was a complication and I spent 2 days in the hospital. I have medicare and Mutual of Omaha insurance. Received a bill for $644.00 to be paid imediately. They finally decided I only owed $67.00. It was for drugs because the operation was supposed to be in and out and they do not pay for the drugs that are used in the in and out facility. Is that ridiculous or what. The price we pay for insurance and now we have to fight for what we can get out of them.

Anonymous said...

Good for you for posting. I hear ya. Regence covered $46 of a $200 dental cleaning (periodontal). I used to get 4 cleanings a year, and now I pay more and only get 3. Hey, Regence. Better rethink your business model. This must be why they cut all their employee pay raises this year. I am surprised their CEO has not stepped down.

Shamir said...

About Canada ... I do NOT have to pay for my cast, and equipment is available on loan from Red Cross equipment loans for free. Nor will I have to pay for my hospital stay or the surgery, X-rays time after time ... and my hospital room was new, with state of the art equipment. Sorry, leaving an impression that we're left in the lurch in Canada is simply FALSE. I will have to pay for the "moon boot", because it was only needed because I got my cast wet. Luckily, my extended plan from work should cover that, when I submit the receipt. Otherwise, all included in Medicare.

Anonymous said...

I have to wholeheartedly agree – Regence sucks! Before signing up with Regence, I called pre-sales and asked many questions, one of which was this: Will my premium be jacked up or raised in any way within the next 12 months? The answer was a resounding, "No, under no circumstance will you premium be raised in the next 12 months. That's not how we do business."

That sounded pretty darn convincing, so I signed up. Less than three months later, they raised the rate from $184 to $214 per month. I called to protest, and "customer service" told me that Regence reserves the right to raise rates as often as they like during the course of the year.

Bottom line: Regence sales and marketing will tell people anything to make a sale, even if they must tell a bald-faced lie. It's akin to selling used cars, and honestly, I've had better experiences with that. Regence Blue Shield sucks.

[I am keeping my name anonymous only because I must keep the Regence coverage for the time being. As soon as I can find a company with integrity, I will be switching away from these lying thieves.]

Unknown said...

Regence is not covering a surgery I need so I don’t continue to stop breathing at night so I can possibly die in my sleep someday. And all they say is we are so sorry for your condition. They one day will get nailed for being a fraud of a insurance company. Karma I hope someday.

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