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» LymeNet Flash » Questions and Discussion » General Support » Ins. Co. changed PCP (LLMD) surreptitiously

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Author Topic: Ins. Co. changed PCP (LLMD) surreptitiously
RECIPEGIRL
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Member # 5884

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Just a heads up guys.

Our insurance company picked a new PCP for our entire family back in August------ supposedly.


My LLMD's office called today & said he was no longer our PCP because the insurance co. had changed it.


(That's impossible because my husband & I saw our LLMD in October.)


We called & the insurance company said it was for our protection----"to make sure we didn't see a non-network physician." Huh?


They said we would get new Ins. cards in the mail with our new PCP name on it. I told him that the Insurance Company stopped putting the PCP Names on the insurance card a while back.


My husband & I both had to call to get it changed back. It still hasn't been changed completely. Our entire family goes to the same LLMD.


While I'm very grateful to have insurance, it doesn't do any good if they won't pay for our visits.

My husband said they're just trying to get out of paying for our 3 upcoming visits.

Just beware.

Jan


Posts: 602 | From Burleson, Texas, USA | Registered: Jul 2004  |  IP: Logged | Report this post to a Moderator
JillF
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Member # 5553

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My insurance did the same to me - and not my husband.

I have no idea why. My doctor isn't a LLMD either.

I got a new insurance card, out of the blue, in the mail one day. Noone else in the family did.

When I called and asked why, they said our PCP was not listed as one anymore. I had already checked on their website and she was definitely listed.

They said they could not find her in their computer so I gave them the number they needed and they said it would not go through.

I told her it had to be her mistake since I was clearly looking at their website where they listed her as a PCP AND that they never changed the rest of the family's cards.

Eventually, after the lady was really rude and ticked off, she 'found' a way to change it.

Before I hung up, I asked her why MY card was changed but noone else's. She said she didn't know.

She was really upset and rude with me, and I was ready to get off the phone with her, so I didn't press her.

I found it really wierd though. It made no sense.

No problems since then.


Posts: 1485 | From USA | Registered: Apr 2004  |  IP: Logged | Report this post to a Moderator
RECIPEGIRL
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Member # 5884

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Thanks JillF for the input.


So it happens to others, too. Strange how they act like you did something wrong. At least you got notified!


Our insurance company makes a huge deal about the "patient" choosing the PCP, & it's just gotta be illegal for them to do that without notifying us.


I understand mistakes; but I don't understand them NOT letting me know about them, so I can fix them.


How could we know to go to our "NEW" PCP if we didn't know the insurance had changed it??? DUH? (That was their rationale)


Anyway, their whole explanation was illogical and I won't bore you with the other ridiculous statments he said.


Just can't believe what they get away with.


After my original call, I called back 2 hours later & asked why they hadn't changed our son's PCP.


They said he was 21 & did I have his permission to change the PCP? (I never changed it in the first place.)


So I put my son on the phone.


I had to do all the legwork correcting their mistake. I felt like "Lucy Ricardo" from "I Love Lucy" by the time I got off the phone.

Oh well. Lesson learned.

Take Care,
Jan


Posts: 602 | From Burleson, Texas, USA | Registered: Jul 2004  |  IP: Logged | Report this post to a Moderator
   

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