Anthem Gym Reimbursement: Fill & Download for Free

I’ve never really had an insurance company “screw me out of a claim,” but I was nearly screwed out of a claim by a bumbling hospital a couple of years ago. It went like this:Since I had suffered from annoying genital warts - which thank goodness cleared up due to the use of an innovative chemotherapy cream - my doctor and I decided I should be vaccinated for HPV to prevent infection with any other strains in the future. My doctor is a great guy, smart as a whip, and an infectious disease specialist at the top of his field. Since I was forty-nine or fifty, I actually made him go out of the room and verify that I was covered. I’m on the Healthy Indiana Plan, Indiana’s Medicaid-like plan for people who get the Medicaid option under Obamacare, and it’s pretty good for the basics. It turns out that the Healthy Indiana Plan pays for the HPV vaccine even in older people. So, I got the $900 vaccine course over three different injections.The bills started coming. Isn’t it annoying how, in the US, the bills sit and sit until paid? That often takes months. Some wise states let the citizen just wait, but in Indiana, you’re supposed to pay and then get reimbursed! Like everybody has $900 or $10,000 just sitting around. I once had a friend who had a claim sit for two years! In fact, they told her she could no longer be paid because so much time had elapsed. “But,” she had told them, “the delays have all been on your end.” They saw her point and eventually paid.So, I ignored the $300, then the $600, then the $900 bill. “It’ll all be paid,” I told myself. Instead, two or three months later, I found that Parkview Hospital and Parkview Physicians Groups here in Fort Wayne had sent me to collections! Um, I’m a CPA and a former international reinsurance analyst - and I KNOW insurance! They were not getting any money out of me.Here’s the story I got out of my insurance company, the very helpful Anthem Blue Cross Blue Shield of Indiana. They shared that:Parkview’s [at least that section of Parkview’s] so-called federal vaccine credential had expired, so Parkview could not have given me the vaccine and gotten reimbursement;I would never be on the hook; andAnthem would gladly try to assist Parkview in getting reimbursed - but that was just because Anthem was being nice, and nothing to do with me.Notice the totally BS point that my doctor - an infectious disease specialist - should only be giving vaccines when working under some obscure “vaccine credential.” That points to the legendary bureaucratic stupidity and wastefulness of the United States. Even so, the rich-as-God Parkview - so rich that it built a quarter of a mile raised walking track around one of its gyms; put in a $40,000 sign in one itsy-bitsy hospital area; and put a $10,000 waterfall in its old facility - should have been on the case. With an army of staff, it absolutely should have known that its vaccine credential needed renewed.It took call after call - as many as ten or fifteen calls - to straighten this all out. At one point, a low-level billing staffer actually got mad at me and hung up. Finally, though, I reached a manager. At first she said she’d look into it - but that might take 45 days. Thinking something was odd, I called back and gently suggested, “Look, this was Parkview’s error - you’re not getting any money out of me no matter what you do. So why don’t you cancel the use of a collection agency and get the bill settled?” She saw reason, and some weeks later, I was off the hook.Never one to leave stuff alone, I called last spring and made sure to tell the billing area - making them listen to every exquisite detail - about how I had been forced to buy a house when the comfy, affordable apartment I was living in was sold; and how negative the impact of a false claim on my credit report would have been during my home purchase. I also thanked the billing area for their help. I made that call to impress on them how important their help, however grudging, had been.The point of this post is broader. It’s to show how totally BS the American medical delivery system is, in all its obnoxiousness.