In a previous rant about Harvard Pilgrim Health Care I mentioned that they couldn't get my child's age right. But the worst, of course, is their chronic problem of losing claims and failure to pay reimbursement in a timely manner. Most recently they lost my claim following an out of town medical procedure and failed three times in a row to send me certain information in the mail ("We don't know why you didn't get that information"). And when they finally did get me the information, it was incorrect.
Now of all things I did (finally) receive payment, only Harvard Pilgrim tells me they overpayed:
Unfortunately due to an inadvertent error you have been issued an over payment of $500.
Because your services were out of network, you are responsible for reaching your 2008 out of network cost sharing. I apologize for this error as I realize you have experienced many unforeseen delays and prior issues in claims processing. Please let me know if you have received this payment so thatwe can discuss a resolution to this issue.
This is the response I would like to send them in return:
Dear Harvard Pilgrim Health Care:
When I am "in receipt" of your claim for overpayment ("in receipt" defined as having received your claim followed by having it scanned in to our system, uploaded to our main system, and transferred to my account) I will take up to (or longer in certain circumstances) 30 business days to respond either with payment or an "explanation of payment" (i.e., a notice explaining why I am unable to provide payment at this time). Please note that New Hampshire law on turnaround time does not include claims pertaining to procedures done out of state, thereby allowing me as much time as I damn well please to provide you with reimbursement or an explanation of payment. Also, if I lose your claim (which is likely) please note that I will not inform you of that fact and that you will be responsible for resending your request. If you would like to use my online claim system for monitoring the progress of the processing of your claim, please request a passcode and user ID which I will fail to send you for several weeks. After that I assure you that I will send a user ID and passcode that does not work.
Of course, I don't really have the nerve to send such a letter. Hey, is there anyone left in the USA who thinks that the coporate approach to managing healthcare which lops off about 25% of our costs and gives it to corporate robber barons is a good idea?
You write a mean letter pilgrim! You should send it, although it might mean a stint in a Federal penitentiary. Why are we so powerless!?
Posted by: behaviorman | February 29, 2008 at 08:04 PM