more2adore
Well-Known Member
I'm hoping I'm putting this in the right forum. It's about insurance, but not as it relates to WLS. I'm having a really, really hard time with my Anthem BlueCross Blue Shield Flexible Spending Account and I know some of you ladies are insurance company experts at this point. I am about to LOSE MY DAMN MIND with Anthem and I need help, if anyone has any to offer.
It all started when I finished using up my FSA right before I quit my job and left the US in December to move to Australia and get married. I double-checked that this was okay to do - it was. As long as any eligible expenses happened before I left employment, they'd be covered. So, I got three pairs of custom compression stockings for my lymphedema (they HAVE to be custom due to my size and the irregular shape of my legs).
This is something that has always, always been covered. My insurance covers it (they paid their part of this expense, so all I charged to the FSA was the copay, which for these ridiculously expensive things was about $600. You don't want to know what the full price is.) My previous FSA companies have always covered it. This is not something unusual.
So before I left the country permanently and moved to Australia, I called them. Multiple times. I had already uploaded the receipt for the compression stockings but they hadn't processed it yet, and I wanted to make sure they had everything they needed.
I called them three times and talked to three different people, who all said yes, they had the receipt, everything was fine with my documentation, and I was good to go. I even logged all these calls to them in my planner and kept a copy of the receipt just in case.
I start getting emails from them in January. "Please log into your online account. We have a message for you." Well, okay. I try logging into the account - "Your account has been closed. You are not permitted to log in." Well, of COURSE it was closed - I left my job and the FSA was closed. So why send me an email telling me to log in? I tried calling them and could never get the call to connect from overseas. So I just figured it was them telling me my account was closed, and continued living my life.
A month later, another "log into your online account message." I try again - nope. Next month, same thing. Finally, they send me snail mail - but to my old address back in the US. Luckily for them it's my parents' address, so my mom opens it and calls me. It says "We need documentation for the charge for the compression stockings." Documentation I've already provided them. So I search HIGH AND LOW for a freaking way to contact them. Found their FSA website (it's a separate division from their insurance division). THERE IS NO PHONE NUMBER AND NO EMAIL ADDRESS listed there, and no way to access ANY info without logging in. Just "consult the back of your card." The number on my card doesn't connect from overseas!
At this point I'm about to hit my head repeatedly against a brick wall. So I go to the regular Anthem health insurance website, go to their "Contact Us" form, explain what I'm trying to do and who I'm trying to get in touch with and that they keep sending me mail to an address where I no longer reside, and telling me to login to an online account they won't let me access and PRAY someone will contact me back.
Finally, FINALLY, three weeks later I get a "secure message" from them. All it is is a boilerplate letter that talks about what they require for documentation. Fortunately I examined the documentation really hardcore and figure out they must be having a problem with the date of service. The date of service is the same date I paid, but the medical place just put "paid date" and didn't list it as date of service. So I stay up past midnight (time difference is killer) to be able to call the medical place, and tell them I need a receipt with date of service. They email it to me. Nope, it still only has date paid, so I go back and forth with them via email a few times until they FINALLY add the words "date of service" to it.
I follow Anthem's instructions for getting it to them -- they offer only fax or snail mail, so my darling husband sets up the printer as a fax machine here and we manage to make an international call work and get it faxed through. I once again mention on our fax to please for the love of Jeebus EMAIL ME if they need to contact me as I am no longer at the address they have on file for me, and their system will no longer let me access the online account they keep asking me to long into. I give them my address in Australia if they must contact me by snail mail.
The next day - I get ANOTHER email saying "Login to your account - we have a message for you." I am headdesking SO HARD at this point. So I forward this message to the same email address they sent the secure message from, and say (nicely) LOOK YOU IDIOTS I CAN'T LOGIN TO MY ONLINE ACCOUNT, WHY DO YOU KEEP SENDING ME EMAILS SAYING I NEED TO? CAN YOU PLEASE JUST TELL ME WHATEVER IT IS YOU NEED TO TELL ME ABOUT THE DOCUMENTATION I SENT YOU. IS IT WHAT YOU NEED?
And I get a secure message back... finally. Open it and it says only "We've mailed our response to your documentation to the address we have on file for you (the one in the US)." Headdesk, headdesk, headdesk, headdesk, headdesk, headdesk! Okay, fine, whatever, I'll wait until that letter gets to my parents and have my mom read it to me over Skype. Then I get another email... "Please log into your online account. We have a message for you." ARGH.
I go back to the secure message I got before and try emailing the "from" address (a specific CSR) directly. No dice - the email bounces back. But at the bottom I finally notice... a DIFFERENT phone number!
So I got up at 6 am on a Saturday here to call the number and try to resolve this craziness. They say I need a letter of medical necessity for this charge... which is fine, I can get my old physical therapist to help with that. It never occurred to me they might need one since this was something I had gotten many times before with my FSA, and never provided an LMN for as far as I remember, but my employer had changed FSA companies and it's possible maybe this one needs such a letter. But sheesh. They NEVER in ANY message they sent me, or in any phone call I made to them in the US before leaving to verify they had everything they needed, or in any letter they've sent to my old address, mentioned a letter of medical necessity. In eight months. Unbelievable. At least I finally knew what they needed from me!
Oh, and they also said I had to include a "cost comparison" which is a screenshot of a non-medical version of the product and they'll cover the price difference. The woman on the phone told me to find an ad for the cheapest pair of regular stockings I could (like 99 cent ones) so they'd cover most of the charge. It's just like.... what? But okay, whatever. I'll jump through these hoops. I pestered my old physical therapist for the Letter of Medical Necessity she'd gotten from my doc to use for the insurance company, she was lovely and sent both it and the RX for the compression stockings to my in-laws, who scanned it and sent it to me. I then get a secure email saying they've received the documentation and I should hear something in 2-3 days.
Well, their reply was AGAIN by snail mail to my old address in the US (I mean, thank GOODNESS for them that my parents live there and not strangers... MULTIPLE DOCUMENTED HIPAA VIOLATIONS, ANYONE?) and this time it says they've decided...drumroll please...
compression stockings are not medically necessary.
ARRRRRRRRGH.
Oh, and I can access appeals forms... through their website... which I can't access because you have to log into it and they no longer let me log in.
I am about to go postal!!!! I really think they're just trolling me for fun at this point.
HELP?!?! PLEASE?!?!
It all started when I finished using up my FSA right before I quit my job and left the US in December to move to Australia and get married. I double-checked that this was okay to do - it was. As long as any eligible expenses happened before I left employment, they'd be covered. So, I got three pairs of custom compression stockings for my lymphedema (they HAVE to be custom due to my size and the irregular shape of my legs).
This is something that has always, always been covered. My insurance covers it (they paid their part of this expense, so all I charged to the FSA was the copay, which for these ridiculously expensive things was about $600. You don't want to know what the full price is.) My previous FSA companies have always covered it. This is not something unusual.
So before I left the country permanently and moved to Australia, I called them. Multiple times. I had already uploaded the receipt for the compression stockings but they hadn't processed it yet, and I wanted to make sure they had everything they needed.
I called them three times and talked to three different people, who all said yes, they had the receipt, everything was fine with my documentation, and I was good to go. I even logged all these calls to them in my planner and kept a copy of the receipt just in case.
I start getting emails from them in January. "Please log into your online account. We have a message for you." Well, okay. I try logging into the account - "Your account has been closed. You are not permitted to log in." Well, of COURSE it was closed - I left my job and the FSA was closed. So why send me an email telling me to log in? I tried calling them and could never get the call to connect from overseas. So I just figured it was them telling me my account was closed, and continued living my life.
A month later, another "log into your online account message." I try again - nope. Next month, same thing. Finally, they send me snail mail - but to my old address back in the US. Luckily for them it's my parents' address, so my mom opens it and calls me. It says "We need documentation for the charge for the compression stockings." Documentation I've already provided them. So I search HIGH AND LOW for a freaking way to contact them. Found their FSA website (it's a separate division from their insurance division). THERE IS NO PHONE NUMBER AND NO EMAIL ADDRESS listed there, and no way to access ANY info without logging in. Just "consult the back of your card." The number on my card doesn't connect from overseas!
At this point I'm about to hit my head repeatedly against a brick wall. So I go to the regular Anthem health insurance website, go to their "Contact Us" form, explain what I'm trying to do and who I'm trying to get in touch with and that they keep sending me mail to an address where I no longer reside, and telling me to login to an online account they won't let me access and PRAY someone will contact me back.
Finally, FINALLY, three weeks later I get a "secure message" from them. All it is is a boilerplate letter that talks about what they require for documentation. Fortunately I examined the documentation really hardcore and figure out they must be having a problem with the date of service. The date of service is the same date I paid, but the medical place just put "paid date" and didn't list it as date of service. So I stay up past midnight (time difference is killer) to be able to call the medical place, and tell them I need a receipt with date of service. They email it to me. Nope, it still only has date paid, so I go back and forth with them via email a few times until they FINALLY add the words "date of service" to it.
I follow Anthem's instructions for getting it to them -- they offer only fax or snail mail, so my darling husband sets up the printer as a fax machine here and we manage to make an international call work and get it faxed through. I once again mention on our fax to please for the love of Jeebus EMAIL ME if they need to contact me as I am no longer at the address they have on file for me, and their system will no longer let me access the online account they keep asking me to long into. I give them my address in Australia if they must contact me by snail mail.
The next day - I get ANOTHER email saying "Login to your account - we have a message for you." I am headdesking SO HARD at this point. So I forward this message to the same email address they sent the secure message from, and say (nicely) LOOK YOU IDIOTS I CAN'T LOGIN TO MY ONLINE ACCOUNT, WHY DO YOU KEEP SENDING ME EMAILS SAYING I NEED TO? CAN YOU PLEASE JUST TELL ME WHATEVER IT IS YOU NEED TO TELL ME ABOUT THE DOCUMENTATION I SENT YOU. IS IT WHAT YOU NEED?
And I get a secure message back... finally. Open it and it says only "We've mailed our response to your documentation to the address we have on file for you (the one in the US)." Headdesk, headdesk, headdesk, headdesk, headdesk, headdesk! Okay, fine, whatever, I'll wait until that letter gets to my parents and have my mom read it to me over Skype. Then I get another email... "Please log into your online account. We have a message for you." ARGH.
I go back to the secure message I got before and try emailing the "from" address (a specific CSR) directly. No dice - the email bounces back. But at the bottom I finally notice... a DIFFERENT phone number!
So I got up at 6 am on a Saturday here to call the number and try to resolve this craziness. They say I need a letter of medical necessity for this charge... which is fine, I can get my old physical therapist to help with that. It never occurred to me they might need one since this was something I had gotten many times before with my FSA, and never provided an LMN for as far as I remember, but my employer had changed FSA companies and it's possible maybe this one needs such a letter. But sheesh. They NEVER in ANY message they sent me, or in any phone call I made to them in the US before leaving to verify they had everything they needed, or in any letter they've sent to my old address, mentioned a letter of medical necessity. In eight months. Unbelievable. At least I finally knew what they needed from me!
Oh, and they also said I had to include a "cost comparison" which is a screenshot of a non-medical version of the product and they'll cover the price difference. The woman on the phone told me to find an ad for the cheapest pair of regular stockings I could (like 99 cent ones) so they'd cover most of the charge. It's just like.... what? But okay, whatever. I'll jump through these hoops. I pestered my old physical therapist for the Letter of Medical Necessity she'd gotten from my doc to use for the insurance company, she was lovely and sent both it and the RX for the compression stockings to my in-laws, who scanned it and sent it to me. I then get a secure email saying they've received the documentation and I should hear something in 2-3 days.
Well, their reply was AGAIN by snail mail to my old address in the US (I mean, thank GOODNESS for them that my parents live there and not strangers... MULTIPLE DOCUMENTED HIPAA VIOLATIONS, ANYONE?) and this time it says they've decided...drumroll please...
compression stockings are not medically necessary.
ARRRRRRRRGH.
Oh, and I can access appeals forms... through their website... which I can't access because you have to log into it and they no longer let me log in.
I am about to go postal!!!! I really think they're just trolling me for fun at this point.
HELP?!?! PLEASE?!?!
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