Doctor’s Office Spends 2 Hours On Hold With Health Insurer For Patient’s Surgery Authorization.

Doctor’s Office Spends 2 Hours On Hold With Health Insurer For Patient’s Surgery Authorization

January 3, 2014 8:19 AM

 

Certified Enrollment Specialist, Marlene Nesmith, waits on the HealthCare. gov website that reads, "HealthCare.gov has a lot of visitors right now!" as she waits for it to allow her entry into the Affordable Care Act website at a Miami Enrollment Assistance Center on Dec. 20, 2013 in Miami, Fla. (credit: Joe Raedle/Getty Images)

Certified Enrollment Specialist, Marlene Nesmith, waits on the HealthCare. gov website that reads, “HealthCare.gov has a lot of visitors right now!” as she waits for it to allow her entry into the Affordable Care Act website at a Miami Enrollment Assistance Center on Dec. 20, 2013 in Miami, Fla. (credit: Joe Raedle/Getty Images)

CHICAGO (AP) — The new year brought relief to some Illinois patients newly insured under the nation’s health care law. Others still weren’t sure whether they were covered, despite their best efforts to navigate the often-balky new system.

The major benefits of President Barack Obama’s health care overhaul took effect Wednesday, the first day of 2014. By Thursday, the first business day of the new insurance system, it became clear that snags in the rollout of the Affordable Care Act still remained.

On the plus side, the law’s protections mean consumers can no longer be denied coverage if they’re in poor health. New limits on how much insured patients must pay for care will mean fewer bankruptcies after catastrophic illnesses. Insurance plans must offer a minimum level of essential benefits, and care such as flu shots and mammograms will be fully covered without cost to patients.

But early problems with the federal HealthCare.gov website led many people to wait until last week to sign up, and insurers are still processing enrollment forms.

Paperwork problems almost delayed suburban Chicago resident Sheri Zajcew’s scheduled surgery Thursday, but Dr. John Venetos decided to operate without a routine go-ahead from the insurance company. That was after Venetos’ office manager spent two hours on hold with the insurer Thursday, trying to get an answer about whether the patient needed prior authorization for the surgery. The office manager finally gave up.

“I’m not a happy camper,” said Nate Zajcew, the patient’s husband. The couple signed up for a Blue Cross Blue Shield bronze plan through the federal HealthCare.gov site on Dec. 16. “I understand it’s just a matter of paperwork and yesterday was a holiday. I can be an SOB, too, at times, but since they’re going on with the procedure, it’s OK.”

Venetos, a Chicago digestive system specialist, described “tremendous uncertainty and anxiety” among patients calling his office recently. Some thought they’d signed up for coverage but hadn’t received insurance cards yet. Others had insurance policies that were canceled and weren’t sure if their coverage had been reinstated after Gov. Pat Quinn decided to allow one-year extensions of canceled plans.

Venetos said he has decided to take a risk and provide care for these patients, at least until there’s less confusion about coverage.

“We feel it’s the right thing to do,” Venetos said. “We may end up stuck holding the bag and not getting paid on these claims.”

Blue Cross Blue Shield of Illinois, which has the most customers in the state’s individual market, has been adding staff and extending call center hours to keep up with demand. “Every week we’re adding staff to our call centers and we’re also enhancing our call routing features to better serve our customers,” said spokesman Greg Thompson.

In the southern Illinois city of Benton, 61-year-old Nancy Pace spent part of New Year’s Day calling Blue Cross Blue Shield to make certain she and her husband were covered by the silver plan they chose on the troubled federal insurance website. “When you get to where it says ‘Pay for your policy,’ well, that button doesn’t work,” Pace said.

Calling the insurance company worked: Pace paid and got her member number over the phone.

“I made a phone call. I pushed the right button and got a live person,” she said.

Pace, a stroke survivor, said she hasn’t had good insurance since her husband lost his job when the mining machinery plant where he worked closed in 2005. The Affordable Care Act means better health care for her and her husband, she said, but she has doubts.

“My biggest concern is, how long is this going to last? How long can our country bear this expense?” Pace said. “It’s a benefit for us right now. But I don’t see how it can possibly be sustainable. … Am I going to use it? You bet I am. For one thing, it’s a law. I don’t have a choice.”

‘They had no idea if my insurance was active or not!’: Obamacare confusion reigns as frustrated patients walk out of hospitals without treatment

  • MailOnline spoke with patients who were told they would have to pay their bills in full if they couldn’t prove they had insurance
  • One was faced with a $3,000 hospital room charge and opted to leave the hospital after experiencing chest pains
  • ‘Should I be in the hospital? Probably,’ she said
  • Another, coughing in the cold, walked out without receiving a needed chest x-ray
  • Consumers face sticker-shock from medical costs under the new Obamacare system, made worse if they can’t prove they’re insured
  • As many as one-third of new enrollees’ applications have seen problems when the government transmits them to insurance companies

 

California Insurance Commissioner: More Than One Million Californians Have Insurance Cancelled Due To Obamacare.

California Insurance Commissioner: More Than One Million Californians Have Insurance Cancelled Due To Obamacare.

November 12, 2013 3:10 PM

 

This Oct. 21, 2013 photo shows the U.S. government Internet health insurance exchange Healthcare.gov. (credit: KAREN BLEIER/AFP/Getty Images)

This Oct. 21, 2013 photo shows the U.S. government Internet health insurance exchange Healthcare.gov. (credit: KAREN BLEIER/AFP/Getty Images)

Group Wanting To Defeat Obamacare Sends Living Wills To Seniors, Begs For Donations

 
Gov. Brown: Calif. ACA Website Has Fewer Problems Than Other States’ Websites

 

SACRAMENTO, Calif. (CBS Sacramento/AP)— Health insurer Anthem Blue Cross of California has agreed to a two-month extension of about 104,000 individual policies after failing to give the required 90-day cancellation notice, state Insurance Commissioner Dave Jones announced Tuesday.

The policies had been set to expire on Dec. 31 but will be extended until Feb. 28 for those who choose to re-enroll. Notices informing customers of the extension will be sent out this week, Anthem said.

Jones said the company notified the Department of Insurance that it failed to give enough notice because of a computer glitch and voluntarily offered to extend the policies.

Anthem spokesman Darrel Ng said a subset of individual customers was “inadvertently omitted from the original mailing” notifying them that their policies were being terminated. He declined to say how many Anthem customers were being notified their policies were ending.

More than 1 million cancellation notices have been sent to Californians as the Affordable Care Act begins allowing individuals to buy insurance through exchanges, Jones said. The federal law requires policies to offer minimum levels of coverage, forcing companies to terminate many existing plans. But Jones said that under the law, insurers have another year to do so.

IN OTHER NEWS:

RIOT blog copy

Every one of us knows America needs revival.  But what would that look like?  America has changed so much that it is no longer possible to give the usual answers to that question.  Here is a conference that combines 4 voices that will give a face, a definition and substance to revival in our nation.

The Conference is called R.I.O.T. an acronym for REVIVAL IN OUR TIME.  It begins this Thursday night November 14th at 7 PM appropriately at the American Revival Center in Martinez,  California.

Who is this conference for?  It is for every any pastor, evangelist, leader or concerned believer who is contending for a moral awakening in the United States.

Why should I attend? You should attend because you will not find a more deliberate attempt to understand and release revival anywhere.  You should attend because the very atmosphere of the RIOT itself will burn out doubt fear and confusion about revival.  You should attend because of the voices that are coming together to speak at the RIOT.

JUST LOOK AT THE SPEAKERS:

riot strip copy

Evangelist Mario Murillo: will host the conference and minister in every session.  Mario has seen true revivals in the most unlikely places in America.  His book Reaching Critical Mass  has been required reading in over 50 schools, colleges and universities including the Bethel School of Supernatural Ministry.

Richard Summerlin Thursday night November 14th at 7PM and Friday November 15th at Noon.

Not far from the scene where Trayvon Martin was killed God is growing a multiracial miracle in an airplane hangar. Richard Summerlin is building the next generation of revival congregations in America.  Thousands have been swept up into the Kingdom of Christ

Richard was a bounty hunter who went after dangerous felons and then became an expert alligator wrestler until he decided to blend his skills and become a pastor.  God has graced Richard with a wisdom and leadership mantle way beyond his young age.  There is no doubt that his preaching and miracle ministry will be an explosive encounter for leaders and all believers.

Sean Smith Friday Night November 15th 7PM

Sean Smith was just a boy when his father was murdered in inner city Oakland California.  Out of the ashes of unimaginable despair and pain God raised up a unique voice to this generation. It began when heaven deposited fire in his soul while he was a student at the University of the Pacific.  This fire turned his pain into the fuel for excellence. Just two years after his total transformation through Christ at the University of the Pacific he led a student movement.

Then the Holy Spirit promoted Sean Smith to full time crusade ministry. He became a global voice and a supernatural gift that devastates the powers of darkness.  He has written several books including the groundbreaking volume I Am Your Sign.

On Friday night at R.I.O.T Sean Smith will bring a word from the Lord that is best described by his mission statement: CARE: Captivate for Christ the hearts of a generation; Activate the army of God to fulfill its destiny; Reach out to and reap lost souls; and Equip the body of Christ to meet the challenge of the Great Commission.

Winkie Pratney Saturday November 16th at Noon and again at 6PM.

After more than three million miles of global travel and sometimes speaking to more than half-a-million annually, Winkie has wide experience in motivating leaders, ministers, educators and young people. Winkie is a mavin, a researcher and public communicator with ability to take existing ideas, break them down to simpler forms and make them practical and freely available to others.

Winkie is considered the greatest living authority on revival. A featured speaker at major conferences, conventions, festivals and other gatherings, his “scholarship on fire” approach has impacted multitudes around the globe, and resulted in the creation or formation of new works to effectively reach, encourage and train young people.

There is no charge for the conference.  Childcare is provided in each session.  There is no doubt that this conference will take revival from the theoretical and the mystical and make it more real than you ever imagined.  See you at the RIOT!

RIOT INSERT FOR BLOG