Wellpoint ( )


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  1. gravatar Iraan Says:
    June 18th, 2007 at 12:24 pm

    I’m not a Wellpoint “customer”, but a little news article I saw in the business section of the LA Times a few years ago summarizes the situation in a nutshell.

    To paraphrase: “WellPoint’s stock dropped significantly on the news that the company had increased it’s payout for patient care from 41 cents to 42 cents/dollar of gross profits.

    What kind of ^&%%!! is this? Well, it’s Capitalism wher Capitalism does NOT belong!!!!

  2. gravatar Jane Doe Says:
    June 26th, 2007 at 11:25 am

    I hope I can offer some help, specifically with pre-existing denials with Anthem/BCBS. I work at Anthem/BCBS in medical review. It is my job to try and find documentation to deny your claims as pre-existing conditions. Please spare me any rude comments or judgment because I already feel horribly guilty about what I do everyday. I am listing some tips here to hopefully save some of you some grief.

    If you have a new policy, whether it is group or individual, get a new doctor immediately. And when you see your new doctor, do NOT mention any providers you have seen in the past. I know it sounds crazy, but if we have no records to review during your pre-existing lookback period (which is generally 6 months prior to your effective date), then we cannot deny your claims. Also, obviously do not list any previous providers when Anthem sends you the letter asking you for this information.

    Also, if you had previous coverage without a lapse in coverage over 63 days, they cannot deny your claims for pre-existing conditions. Just send them a copy of your certificate of prior coverage.

    Honestly, I do understand why health insurance companies have the pre-existing clause in some cases. You wouldn’t wreck your car and then try to go get car insurance so it is the same thing here. It is morally wrong to be diagnosed with lung cancer when you are uninsured and then try to go get health coverage.

    But in the same breath, I am embarrassed and ashamed at some of the claims I am forced to deny everyday and I have experienced it myself, first hand with my own family. We have horribly high premiums and lousy coverage and I am their employee, go figure.

    Secondly, the whole “consumer driven” health plans like HRA’s and HSA’s are even worse than the traditional PPO’s and HMO’s we have now and the govt is going to try pushing these on us in the very near future - they may even be the only plan we are offered by our workplace. Total sham, I tried it out last year and was out several thousands out of pocket and we have a relatively healthy family. So I really pray it doesn’t come to HRA/HSA health plans only…you should too.

    I hope I helped at least one person out with my little bit of pre-existing advice. If I think of anything else, I will be sure and add it.

    “Jane Doe”

  3. gravatar Jan Says:
    June 27th, 2007 at 3:50 pm

    I have a friend who works for Wellpoint. He’s been there less than 3 years and received a $10,000 bonus at the end of their fiscal year. Everyone gets a bonus, the longer you’ve been there and the more they make the more the bonus is to the employee. So if you have a loved one who is sick and a large medical bill they are denying, you should call an employee there and ask them to pay your bills!

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