Strange Call from insurance company

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  • JanetM
    JanetM Member Posts: 336
    edited October 2011

    Contacted my insurer this morning and after a little run around finally spoke with someone.  She indicated that the call was from a provider they use to deal with people with chronic illnesses (didn't think I was at that point)..Her explanantion was that the call was generated either based on a survey that I filled out (which I didn't) or by the number/type of claims that were submitted (many over the last 6 months).  So I guess I spent too much of their money in a short period of time.  Still bugs me that they do this.....

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  • cycle-path
    cycle-path Member Posts: 1,502
    edited October 2011

    I saw a program recently on PBS about an inner-city hospital that did a pilot program in which nurse-navigator types were periodically sent to the homes of people who had been incurring a lot of medical expenses. The nurses consulted with these patients on a variety of health issues over a period of time -- maybe a year or two.

    It was found that this program resulted in significant cost savings and also in better health for the patients.

    I think insurers are attempting to do something along the same lines.

    Presumably part of the problem with many of these inner-city patients is lack of knowledge and resources that can help them deal with their medical issues, and probably most of us who read BCO have much more knowledge and resources (resources such as BCO). We're probably all "above average" when it comes to education and and BC-related resources. Maybe it will eventually be determined that this kind of assistance isn't helpful to those in our demographic and they'll stop offering it to us.

    Most of us despise our insurance company, and usually with good reason, so nearly any call from them is suspect. But if we were less educated patients with fewer resources, the offer of help from the insurance company might be welcome and useful.

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  • NatsFan
    NatsFan Member Posts: 3,745
    edited October 2011

    Sue - thanks for the perspective from the other side.  I've also gotten calls from nurses after surgeries checking to make sure I was OK and offering to answer any questions.  The thought is very nice.  However, since they are under the pay and direction of the insurance company, I felt there was a potential that that the advice I would be given would be more in the insurance company's best interest than in my best interest.  I didn't feel as comfortable talking to them as I would to my own doctors and others on my medical team.  I was very circumspect in all my conversations. 

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