Showing posts with label Anthem. Show all posts
Showing posts with label Anthem. Show all posts

Monday, March 8, 2010

More insidious than stealing money, Insurance Companies Steal our Time


Luna practices taking her shoes off before her Synagis injection.

Last week was truly one of the most difficult of my life. Many of you (and I cannot thank enough those who sent emails, tweets and comments of support, you literally carried me through) followed along as I tried in vein to get Luna her last Synagis shot of the season.

The week came to a triumphant end on Friday when I received a phone call from a woman at WellPoint, the parent company of Anthem, and center of loads of negative media attention over the last several weeks; as the CEO was called to testify before congress to defend her nearly 10 million dollar a year salary (a mix of salary and stock options, this number does not include her private jet usage another other perks). WellPoint and subsequently Anthem, earn their profits through the percentage of their earnings that don’t go to healthcare; paying doctors or for medicines and treatments. In other words, it doesn’t take much to connect the dots on why the insurance companies would have virtually no incentive to pay for the costly Synagis treatments. And it is this very jump in profits, during the deepest recession in 80 years, that has caught the eye of Congress.

The WellPoint representative called to say she was following up to my letters I had sent earlier in the week. (I had sent a letter along with my blog posts to both Anthem and Precision RX customer service.)

And apparently I caught the attention of the CEO of Anthem.

But back to WellPoint for a moment. The woman who called was incredibly kind. She said that she was following-up to make sure the Synagis was shipped to Luna’s pediatrician. I told her, "Yes, I had received a phone call from our doctor's this morning confirming delivery".

She went on to say they she was reading my blog, and she and her colleagues at WellPoint, along with her colleagues at Anthem were cheering Luna on.

I was touched. Really. I almost burst out into tears.

But then she went on to say that: lot's of people complain, but I had written in such a compelling way that I wasn't pointing fingers, or ranting, I had told a story about a little girl who was not getting her medicines.

I was honestly moved by our conversation and flattered by her kind words...but I still felt a sour taste bubble-up in the back of my throat. I happen to write for a profession. And I offer social media and publicist services to those in the home and garden industry. And to date I have successfully reversed nearly $8,000 in denied claims through the power of twitter.

But what about those who don't write, tweet and blog for a living? I am, in a sense, an expert complainer. And even I sometimes don't communicate the best I can-simply because I am exhausted in trying to keep up with this thing we’ll simply-call-the-insurance-madness, ON TOP of running my business, along with...you know...that other duty that still no one has given any real value to; that of course being a mother.

So, while I appreciate the kind words, is this really the best we can do?

Perhaps my biggest complaint of all is the time that Anthem steals from me. Last week I put at least 80% of my work time into what many of us call The Synagis Nightmare. Time that is not just taken from me, but since I represent architects, designers and photographers, we can justifiably say that Anthem stole their time as well. And time is money. If I'm not out pitching, writing, blogging and tweeting for my clients; it's only diminishing my efforts to land them more clients.

Since posting on the topic; dozens of mothers and fathers have emailed or stopped me to say their Synagis has been discontinued for their preemie, heart baby, or child with cystic fibrosis.

Which once again begs the question: why do the makers of these powerful and lifesaving drugs bother to tease us? If no one can afford them, and the insurance companies have no incentives at all to pay for them; then what is the point?

And back to Luna's Synagis shot. It dropped from $2791.64 to $1825.13, still no one has been able to tell me why. Just a week ago, before I blogged about the topic, the shot would have cost our family nearly $1000 more.

Thursday, March 4, 2010

Synagis Follow-up

Yesterday I posted a blog about, how Luna and I were treated like circus animals (as described brilliantly by one of my friends)-all in our quest to get our two year old a much-needed and time-sensitive shot called Synagis.

Just after I posted my blog about the Synagis/Anthem/Precision RX heist, I sent the post, along with an email to the aforementioned parties.

By 6pm when I heard nothing from any of the three, I have to say, I was feeling flat-out depressed and started contemplating how I could get my family out of this country, and into a more civilized nation; one where healthcare runs smoothly and affordably-and one where half the population isn't crying government takeover (a very clever and carefully crafted message to instill the very outcome it's generated).

Finally, last evening I checked my email around 7:30pm and a rep from Anthem had written to say "thank you for the note" and asked me what state we were in-to which I replied immediately: New Hampshire.

About a half hour ago, Precision RX, the suppliers of Synagis, the shot that Luna is now about 3 weeks over due for; called to follow-up.

This is what the very kind (and really, the reps-all women-are truly nice, it's the system that is maddening) said:

"Renata from the pharmacy solutions department at Anthem called to say that your co-pay for the drug would be $1825.13, and to go ahead and process it immediately".

This new figure of $1825.13 is indeed wonderful news, a vast improvement over the original $2791.64 that was due.

And somehow (as in it took a day of blogging, tweeting, emails and phone calls) everyone is perfectly fine with billing the balance after the $800 down payment into monthly payments of $512.57

I asked the Precision Rep why the co-pay dropped nearly $1000, and she could not answer.


Footnote: I actually had a few angry commentors to my previous post, one in particular called me, "full of crap". I think the most diplomatic rebuttal is to say, I love business, and if you are selling hand bags, furniture, jeans, paper clips and even coffee; by all means, sell for the highest you can!

But when it comes to lifesaving drugs, medicines, and medical treatment for kids (and adults); shouldn't we be a bit more transparent with the cost and yes, fixed with the fees for these services?