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  #1  
Old 01-26-2011, 04:52 PM
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Health Insurance shennanigans

Not sure what to make of this... seems these folks could (and SHOULD) simply have paid their $.02 bill and been done with the matter. There's no arguing that they failed to pay their bill in full. Still a sad case. Moral of the story? If you find evidence of billing discrepancies, CHECK THEM OUT (or, for God's sake, send in the two cents).

http://www.thedenverchannel.com/news/26614998/detail.html

Insurance Company Drops Vet Over 2-Cent Shortage
Cancer Patient's Life Now Hangs In Balance As He Awaits Stem Cell Replacement
Russell Haythorn, 7NEWS Reporter



Those 2 cents could cost Vietnam veteran Ronald Flanagan everything.

"Everybody we talk to is very surprised that 2 cents is enough to do this," said Flanagan.
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It was an innocent enough mistake, according to Ronald's wife, Frances Flanagan.

"If I only had just hit the nine instead of the seven," Frances said.

When she was paying their monthly health insurance premium online in November, Frances swapped a 7 for a 9, leaving their $328.69 payment 2 cents short.

"And now we're just pulling teeth and trying to figure out what's the next step," Frances said.

Their insurance benefits administrator, Ceridian Cobra Services, based in St. Petersburg, Fla., promptly dropped the Flanagans for the 2-cent shortage.

The couple found out about losing their coverage at a doctor's appointment on Jan. 13 while they were at the Exempla Rock Creek Medical Center in Broomfield.

As Ron was getting prepped to have a bone biopsy, Frances was on the phone with Ceridian.

"The nurses were just getting ready to do the biopsy when my wife popped into the office and told them, 'Stop. We don't have any insurance,'" said Ron.

"And that's when they let me know that we no longer had insurance on account of the 2 cents, and they canceled us," said Frances. "Since then, I've been depressed. I haven't been able to hardly do anything. As you can see, we still have our Christmas decorations up. So it's been hard on me."

Ron has been fighting cancer since September 2008. He has multiple myeloma -- cancer in the bone marrow. Doctors at St. Luke's have performed stem cell transplant surgery twice. He needs another transplant before the end of February, and they have a donor. But because of the 2-cent mistake, Ceridian Cobra Services will not pay for the procedure.

In a statement, Ceridian Cobra Services told 7NEWS, "We did not receive a full and timely payment and (Mrs. Flanagan) was provided several notices of the shortage and a grace period reminder notice on the last invoice, along with extended grace dates as provided for under COBRA regulations."

The statement goes on to say, "Since the payment was not full, it fit into the definition in the regulations of an 'insufficient payment' ... Ceridian understands nothing is more important than one’s health ... Unfortunately, we simply do not have the capacity to be able to personally call continuants and remind them of the status of their COBRA benefits."

Ron Flanagan believes Ceridian does not value human health, but rather, the bottom line.

Ron said they never received written notice that they could be dropped. The couple said they only received a billing statement in December that showed the two-cent shortage, but it wasn't clear to them that it was past due, otherwise they would have just added two cents to their December payment -- which they paid in full, and which Ceridian promptly cashed.

"They never did a certified letter saying what could happen. They never made a phone call. As far as I'm concerned, they're looking for a way to drop you," he said.

The family believes the cause of Ron's cancer is likely exposure to Agent Orange while Ron was deployed in Vietnam. Now, he waits for the stem cell transplant he needs.

"My doctor said I could not wait months to decide on a transplant," said Ron.

"I spoke to my sister-in-law and that's when I broke down. And I told her I feel like it's all my fault," said Frances. "She just said, 'No. It's not your fault.'"

"The insurance company is paying out way more than I'm paying in. And I understand that. But, that's part of the insurance game," said Ron.

"We have God on our side," said Frances.

Ron is now considering going to the Veterans Administration hospital as an alternative, but it could mean he would have to travel to Seattle for treatment.

Federal law states insurance providers must give you a reasonable amount of time to make up a shortage.

Ron said he might start oral chemotherapy as a maintenance-type drug to manage his cancer.

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  #2  
Old 01-26-2011, 05:06 PM
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Ceridian could have just called when they noticed it.
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Old 01-26-2011, 05:12 PM
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Quote:
Originally Posted by Kuan View Post
Ceridian could have just called when they noticed it.
Ceridian was doing what it takes to get rid of a bad risk.
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Old 01-26-2011, 05:15 PM
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Ceridian needs one of those "need a penny" plastic cups at their front desk.

I remember at Domino's we'd just make up couple pennies difference if the customer was short.
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  #5  
Old 01-26-2011, 05:16 PM
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Well......anyone who has made payments "online" knows that it isn't too difficult to make a mistake. But, unlike paying your Sears charge card, we are talking about your HEALTH. Slip up two pennies worth and your health insurance is history.......

Thank you for your prompt premium payments for the past twenty years, we really appreciate it. But because you ACCIDENTALLY shorted us two pennies means we are cutting you off at the knees.

(As the insurance claims agent hangs up the telephone and turns on her boom box which blares out Queen singing, "ANOTHER ONE BITES THE DUST")
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Old 01-26-2011, 05:22 PM
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What I don't get is why the folks didn't just pay the $.02 bill when they got it. I do suspect Ceridian might have given a little more leeway to a low-risk customer (or, rather, a customer who wasn't costing them bundles of cash). Look at those bills carefully!
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Old 01-26-2011, 05:28 PM
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Quote:
Originally Posted by cscmc1 View Post
What I don't get is why the folks didn't just pay the $.02 bill when they got it. I do suspect Ceridian might have given a little more leeway to a low-risk customer (or, rather, a customer who wasn't costing them bundles of cash). Look at those bills carefully!
especially health insurance premium notices. It's a lot different than shorting the electric company. You can live without lights, but not having health insurance can literally be the death of you.
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Old 01-26-2011, 08:41 PM
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They're all a bunch of ****kers, insurance companies and bankers, and they will JUMP on any chance they can find to **** you. Not surprising.
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Old 01-26-2011, 09:20 PM
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Originally Posted by elchivito View Post
They're all a bunch of ****kers, insurance companies and bankers, and they will JUMP on any chance they can find to **** you. Not surprising.
golf clap.......very true...they call it loss or risk management......
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  #10  
Old 01-26-2011, 09:25 PM
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good news, he has been reinstated....

http://www.thedenverchannel.com/news/26626470/detail.html
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  #11  
Old 01-26-2011, 09:29 PM
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Originally Posted by Txjake View Post
good news, he has been reinstated....

http://www.thedenverchannel.com/news/26626470/detail.html
That's good news -- I am sure the press exposure helped. Bet he opens all his bills from now on!
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  #12  
Old 01-26-2011, 11:01 PM
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I think the company felt that some form of insurance regulator may have paid them a visit over this. Or they got a phone call.

The bad public disclosure and attention it generated otherwise would have perhaps passed with time. The public is all too well aware that any excuse at all can cancel coverage. It is far from a new concept.

Whatever I am pleased he was reinstated. The media does help from time to time.
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  #13  
Old 01-27-2011, 12:05 AM
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I thought all these injustices were cured by the passage of Obamacare. And healthcare is going to be more affordable.............
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  #14  
Old 01-27-2011, 08:45 AM
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what got me was it said the ins company cashed the next premium check they sent.maybe they didn't want this vet going commando on their headquarters with the token ak-47.that would really generate some good press for the company.
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Old 01-27-2011, 08:49 AM
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Figures its a COBRA administrator. They want you OFF the books.

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