I have been paying premiums to them since June I 2009 and went for a Doctors visit on July 1 with a network doctor who ordered a routine blood workup since I have not had any exams in years.
The clinical lab bill was sent direct to me and I filed a claim with them on 7/31/09. I have had to call them every month inquiring about the status of payment, first the run around process, then the lab is a network provider so billing has to be adjusted on the rates, then claims department is checking on it and now the latest twist is I need the Doctor to sign a form showing it is not a pre existing condition for the claim to be paid.
Now this would be funny if they actually paid for the blood test but the policy is clear a fifty dollar reimbursement for diagnostic test, so what is there game, re rate the whole bill great that might save me some money for my cost portion if and when the EBO
(explanation of benefits) is finally sent out. But Please a pre existing condition for a CBC complete blood count which is so standard for any doctor to assess the general state of health and perform a physical.
Now after some research I see the underwriter AMLI is barred from selling these policies from the NewYork insurance commissioner and just where does that leave us with pending claims?
I was looking forward to the "credible coverage" of this policy to help in getting major medical from a real health insurer but now realize I should probably cut my losses and cancel from this company before they charge next months premium and by the look of other reports that might mean canceling the credit card since they do not accept cancellation request and now I have spent premiums for nothing.
I will have to check with the doctors office and see if my exam was paid for or not and am hoping the 50.00 dollars they are contractually bound to pay for the diagnostic test does come, not very confident of that after all that I have been through and now researched about this company.
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