Insurance scam?

MariannaLaFrance

OK, didn't know where to post this one, but thought you ladies might be able to chime in.

So, my healthcare provider sent me a letter saying that I have a case manager, and that I should reach out to her to get tips on how to manage my health benefits, connect with resources, etc.  So I called the line, which has an R.N. staffing it. I started off the conversation by saying "So I guess you can see my breast cancer diagnosis......" to which she quickly responds with "N!o! I absolutely cannot see that information. I would like to inform you that this call may or may not be being recorded for training purposes."  She asked me again after that if I had an UNDERLYING condition that I would like to disclose, and by this time, I was very alarmed. I told her that I had no such thing to disclose, especially since I had heard that United HC had discontinued benefits to several breast cancer patients in the state of WA upon finding out about their condition.....

I think it's fishy that I was sent a letter that looks as if they are "in the know" of my "condition", but yet they don't seem to know anything once I called. AND the nurse on the line was not very helpful, as she was not going to give out any health care advice to me. I asked her about vitamin supplementation!!   She would not recommend any course of treatment, would only give me names of doctors in my area.

Interesting. Am I right to be a bit cautious with releasing information here? I was a bit alarmed by it all.

I guess I should say what alarms me is that I feel like they might be scrutinizing me since I've racked up a few bills, and they are considering putting me on the "do not issue any more health insurance to her" list!!

OneBadBoob

PLEASE BY ALL MEANS BE CAUTIOUS!!!

I had a similar problem with Healthnet, where some third party called me offering me social security benefits and medicare if I would release certain information to them.

I called my case manager at Heathnet (with whom I had spoken before) and she was totally unaware of this practice!  Indeed, she was on the up-and-up.

I ended up reporting it to my congressman and senator, who brought it up before the Health and Human Resources Commission, as a violation of HIPPA laws.

These creeps rot!

rreynolds1

Any suspicious calls should be reported to your Dept. of Insurance.  They can evaluate whether these calls are on the level and do something about it if the calls are bogus or not in your best interest.

Roseann

althea

I remember getting one of those letters from my insurance company a long time ago.  I never did call to pursue 'managing' my case.   I can imagine that my experience would've been similar to yours.  I'm also remembering vaguely that some people were losing their insurance when it 'came to light' that there was some kind of preexisting condition that was not previously revealed.  I can't remember details.  I just remember thinking that it's mighty tacky to be so concerned about it in the midst of a serious health condition -- after taking thousands of dollars in premiums.  I'd be suspicious that they's be wanting to 'manage' not having me as a customer anymore. 

jenn3

I have BlueCross/Blue Shield and had a case manager, she was very nice and I enjoyed talking to her.  However, my reason for being cautious was because she worked for the insurance company, not my doctor.  I know it sounds cynical, but her paycheck comes from BlueCross, not from my healthcare providers.