Friday, March 14, 2008

Capitol Blue Cross is really getting on my nerves

So for the second time this year, they've denied payment a major medical procedure.

I had electrodiagnostic testing done for Carpal Tunnel. I indeed do have that injury. Capital Blue Cross denied the claim, stating in so many terms it wasn't medically necessary. (Apparently, the doctor tested too many nerves. Um, no he only tested one major nerve and its radial branches present in both arms. How is that too many nerves?)

I find that interesting since I have done tons of homework on Carpal Tunnel and the best way to determine if someone has the condition is through electrodiagnostic testing (essentially, they take a low voltage and and shock certain points along the nerve to check the electrical impulses. It's non-invasive. They had to do this in both arms, as I have it in both arms.Yes, Capitol Blue Cross, it is indeed possible to get Carpal Tunnel in BOTH arms. Imagine that!) How in the heck is this not medically necessary, when it's the BEST way to get a CONCRETE diagnosis? Riddle me that, Batman.

I don't see the purpose of having medical insurance if they're just going to deny payment for everything and not give decent concrete reasons why other then "it's not medically necessary," when there's really no better way to test for the condition then the procedure (which isn't even that expensive a procedure!) I had done is. So I don't see the point in bothering to go to the doctor, since Capitol Blue Cross seems to not want to bother paying for anything, even though I ALREADY PAY FOR IT ON A BI-WEEKLY BASIS.

Yeah, best health care in the world. Whatever. And Capitol Blue Cross wants to expand statewide. I chose them because they were concentrated only in this area, other then the other ones offered to us who are national organizations and have some pretty big black marks against them too. Statewide just dilutes the brand. Maybe they want to be like their brother Blue Cross organizations, all of whom suck.

1 comment:

Anonymous said...

I wonder if it's a PA thing? I had health insurance in PA (forget the company now - but a major one) and had claim after claim denied - including primary care physician visits.

I have had Blue Cross in NY since I was very little (except for the 2 yrs in PA), adn NEVER have had nay problem and claims denied. Of course, the Rochester Excellus Blue Cross is the flagship of the BCBS system.

OTOH, the Dental program sucks.

-Peter (rfeceo)