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I got a hen, she’s a good ol’ hen; she lays eggs for the railroad men
So, an interesting day, so far. Had fresh-bake bread for breakfast, with mint jelly (mmmmm, mint jelly); set the new coffeepot cleaning, so we can have new-coffeepot-coffee tomorrow morning; and called Anthem Blue Cross, our supposed health insurance company, to find out why they had denied an echocardiogram for my husband, a heart patient.
This is interesting — no really; it is. See, Anthem doesn’t make “determinations” — they simply exist to take your money — there’s another company, something called American Imaging Management, and its purpose is to deny medical procedures in order to save their stockholders money review the available data to determine whether a prescribed test actually is, in their sole opinion, necessary.
It comes about that American Imaging Management decided that the diagnostic echocardiogram was not necessary, in Steve’s case.
I asked the customer service rep at Anthem where we went from here — just show up in the cardiologist’s office with a couple thousand-dollar-bills in hand and get the test off our own bat (which, to be Perfectly Fair, is what’s going to happen, anyhow, we having the Pay-Anthem-$600/month-so-they’ll-say-we-have-coverage-while-we-pay-all-medical-bills-out-of-our-own-pocket-anyway Special for folks who have made Bad Life Choices and don’t have a Good Job with health care benefits plan).
The service rep actually went the extra yard, and called American Imaging Management for me. He reports that AIM declares that their ruling may be appealed. All that needs to happen is that Steve’s Actual Doctor call a Doctor on Staff at AIM, and, well, convince the staff doctor that the test is necessary.
Easy-peasy, right?
After that conversation, I was more than ready to go to gym, and so I did. Back now, with a bunch of cut ‘n paste in my afternoon, and a list of interview questions to answer, when I get bored.
While I was gone, Steve has been doodling around in the new Cafe Press store — I hear there’s tree-and-dragon jewelery to be had at the Hyperspatial Boardwalk Shop, along with the usual t-shirts, bags, clocks and teddy bears. Check it out.
I have also been remiss in announcing that the Fourth Klamath Splinter is now up at Splinter Universe. Progress had been set back due to scanning issues, which have now been resolved. We thank you all for your patience!
And now! Cut ‘n paste.
No. No, the excitement never does stop, why do you ask?
Originally published at Sharon Lee, Writer. You can comment here or there.
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Hyperspatial etc
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Good luck!!!
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Consumer Health Care Division
Maine Bureau of Insurance
34 State House Station
Augusta, Maine 04333
Website: http://www.maine.gov/pfr/insurance/consumer/CHCD_Brochure.htm
Phone: 1-800-300-5000
Serves residents enrolled in private health insurance.
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Insurance
Klamath Splinter