Letters from insurance co telling us to see dr.

[eyeamdry]

This might be a twist on the posts about the "Managing Nurse" letter coming to patients.

In today's mail were seperate letters from our Insurance Co (with MA contract) saying "we care about your health  and want you to feel your best.  One way to meet your health needs is by going to your doctor.  We know that this helps people control and manage their health problems.

Please schedule a visit with your doctor to follow up on health matters that may have been an issue in the past.  You may have a co-payment with that visit."

HERE IS MY AHA MOMENT:

It is our goal to work as a team with you and your doctor to manage your health care needs.  Always tell your doctor about any changes you have had in your health.

Sincerely..................Federal Business Division

My and my husband have at least 3 different doctors and that's a short guess.  I smell a rat and don't like this one bit.  I have an upcoming appt with my GP later this month for a pre-cert for knee replacement.  I had to book this 5 weeks in advance.  Any other time, we see his two PA's.  Same with my rheumy, it's always the rheumy's PA you see first, then if you want to wait another hour or two, you can see the doc.

I see Big Brother hovering around our medicine cabinets.  The letters were individually name/addressed, but they looked like they were sent bulk rates.  It even has a letter "name".  We can be looking for more of these.  Lucy

[4Kids]

Disclamier:  **I am Canadian and believe in Medicare**

So I am confused. is your letter from Private Insurance? or the government department responsible for your health care spent (I have no idea if this would be the State you live in or the federal government?)

Here in Canada, the federal government doesn't get into your health care, it is managed through your doctors so to me, Big Brother doesn't get into our medical affairs. As I see your letter, it is more your Health Insurance (private, I would think) that may be doing that and government intervention (as I experience it) in canada could stop that, not hurt it.

But I may not understand fully. Also, I understand a lot of Americans do not believe in our system (as I have a problem with yours).

Ours has many problems. Referral times, not enough specialists... many, many problems. But I believe in the government paying for medical care (through taxation).

(and I wonder if your thread should be moved to the other board. lol. sorry to be such a pain!)

Jackie

[Joe S.]

First I want to respond that my oldest daughter is now a citizen of Canada and prefers the medical system there to here in the USA.

Now, Lucy, remember that insurance is legalized extortion. It was legalized in the USA to take it out of the hands of criminals. The criminal enterprise of Insurance (extortion) is privatized and legal.

Insurance companies like all corporations are out for maximum profit. Some corporations as paper people have no morals and will do anything to improve their profits. I view their offer of assistance with skepticism. My view is from experience. Maybe you have a good insurance company that is looking out for you in you best interest.

[Diane54]

I have a nurse manager from my insurance company. I thought it was a good idea ...well sorry I even got involved! She calls every two weeks and it's at the point that I won't answer my phone. I know when I need to make a doctor's appointment....I know I need to control my diabetes, take my antidepressants etc....if anything this woman is causing me more stress than what I need! She acts like I am a child and not 57 years old....then she repeats and repeats these goals she has for me.....I wish I could block the number to be quite honest! Maybe it's me being too critical but I know what health issues I have ....I live with them on a daily basis and until she can give me some good feedback that I can appreciate .....  then just leave me alone!

By the way this nurse never heard of SS!

[jazzlover]

Wow... the RN who calls me is very nice and I only hear from her about every 3-6 months...depending upon how well I am doing. I'm pretty sure you can refuse the service.

If we ever go to national health care here in the US, I guarantee that the government will be very much involved in my health care.... with a negative effect. It's bad enough now with insurance companies dictating what our doctors can or cannot do.

[Diane54]

What really irks me is that she keeps pushing me to see a therapist....like everything I am experincing is in my head! That was the last straw a few weeks ago.....Maybe if she called once every 3-6 mos I would be more inclined to tolerate her but this every two weeks is really nerve wracking.  She told me on the first call that she has never heard of Sjogren's... and she really hasn't educated herself on it either....she keeps asking what a flare is like yada yada.....I get tired of explaining my situation every two weeks to someone that doesn't seem interested enough to read up on what I am dealing with

I am sorry that this is a somewhat negative post but I think that maybe some of us need to know that some of these "nurse managers" that work for insurance companies aren't all that! I expected her to be more informative dealing with my issues and more helpful but this doesn't seem to be the case. Of course that does not mean that THIS could happen to you...just be aware that it does happen!

[Still in the hunt]

Now you kow what i go through,, letters saying we care about your health,, we want the best for you,, no you dont,, as long as you get your premium every month,, your happy, money talks Bull sh&& walks

[jazzlover]

Diane... try to dump her and see what they say. Would be interesting!

[irish]

I would be very careful about how you dump her. These insurance companies are getting more cagey all the time. I would want to know if it is necessary to have a nurse manager and what the outcome would be if you dump her.

When they start telling you who to see and don't even know what the disease is ----sheeesh!!!

I would find a couple of website and suggest that she go educate herself on this disease.  Also, if she continues to harass you I would consider calling the insurance commission in your state and finding out what you rights as a paying customer are.

There is also the Better Business Bureau also.  I received severeal letters in the last few years tellling me to call, etc. I never did!!! I figured I am a big girl and if I have problems I can call someone at the clinic or talk to a doctor.

What am I thinking??? You must be dealing with a government health care---or is it a private pay health care company??? Irish

[Joe S.]

Yes, If you already have one, it is difficult to get rid of them. You have to handle it very carefully. Catch them in a lie. BBB complaint... These may be options.

[Diane54]

This is insurance through my husbands employment!

[Patze]

Oh my, do I remember those days!  I sure don't wish that mess on anyone!

Once had an insurance that was like that (someone always telling me that there was "nothing" wrong with me (this was an HMO)), and if they would have done a thorough exam, they would have noticed that there was indeed something wrong.  What bothers me more is that they probably knew but didn't want to "spend" the money on surgery.

The last time that I saw one of "their" doctors, I was told that I should use this or that med (unknown to me at the time, but they were offering me antidepressants).  And I was "allowed" to see one of their psychologists...yep, it was all in my head.

Finally changed insurance companies and went to a doctor who picked up the problem on the first visit, had surgery a couple of months later and was fine after.   Oh yes, it was all in my head!

Sending { { { H U G S } } } to all those who have to deal with "case manager" and over involved insurance companies.


Patze

[Calli66]

Have you requested they give you a different case manager? This one sounds like a real over-achiever with the constant calling. Maybe it's one of those work-at-home positions with the company ---paid by the number of calls she makes, maybe?

Just another example of insurance companies showing that they "really care" but they are just paying somebody to pester you and see if you're really sick. And I guess if you object to this sort of attention they can label you as "non compliant," giving them reason to deny treatment in the future.

Cynically,
Calli

[Still in the hunt]

It is a dam if you do and dam if you dont, they have a set of questions they ask,, and you know your being recorded (for quality purposes) or (training purposes),,, it seems to me the questions are almost a set up,, they allready know the test you have had done,, I know becasue they have told me,, and heaven forbid you start to get a bit testy when they say that depression word, these people have no idea what depression,, when you deal with a chronic illness,, of course your going to be depressed,, so they zero in on that one answer, I made that mistake when asked if I was depressed,, of course I am,, dealing with this everyday is depressing enough, so the story starts to twist,, do you have anyone to rely on,, I see its just you and your wife at home,, and she works full time,, so that leaves you alone at home,, do you feel like you might harm yourself, the list goes on and on, but always rememebr,, your being recorded,, and who knows who listens to this,, heck the janitor might for all i kow,
  These eople are ruthless,, I was asked if i was going on vacation,, are you nuts lady,, I am lucky to make it out the door to walk the dog, without stumbling and falling,, or I am asked, do you have anyone to help you durig the day, well there was my sister,, she moved in next door to help me out,, now its more like I help her out, its bad enough when you get no support from your own family let alone some overzealous case manager or represenstivie from teh insurance calling you up constantly,, I have caller ID and just dont answer the phone anymore,,