Calif. Blue Cross Asks Docs to Report Patients’ Omissions

[cyclezealot]

Don't you think this kind of requests on the part of insurance companies, its only a matter of time until the AMA and insurance companies become political opposites?
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Blue Cross of California is trying to enlist doctors’ help in finding patients who failed to report medical conditions when they applied for insurance, the Los Angeles Times reports. Docs aren’t rushing to respond.

“We’re outraged that they are asking doctors to violate the sacred trust of patients to rat them out for medical information that patients would expect their doctors to handle with the utmost secrecy and confidentiality,” Richard Frankenstein, president of the California Medical Association, told the paper.

Insurance companies are sometimes allowed to cancel individual policies for people who failed to disclose pre-existing medical conditions on their application for coverage. But there are limits to when they can do this, and Blue Cross of California, which is owned by WellPoint, was fined $1 million last year for inappropriately canceling some policies. The company is fighting that decision.

Blue Cross recently sent this letter to docs, along with the the patient’s application for coverage for the doctor’s review. “We ask your assistance to identify medical omissions because you, being the primary care provider, will have first-hand knowledge of services provided and/or requested.”

Efforts such as this are nothing new, a WellPoint spokeswoman told the paper. “Enrolling an applicant who did not disclose their true condition (and the condition is chronic or acute), will quickly drive increased utilization of services, which drives up costs for all members,” she said.

Update: Under withering criticism, Blue Cross of California said it would stop sending letters to doctors asking them to help find patients who had failed to report pre-existing medical conditions to the insurance company.

http://blogs.wsj.com/health/2008/02/12/blue-cross-asks-docs-to-report-patients-omissions/

[Hekate]

1. We have Blue Cross through my hubby's job, and pay through the nose for it...

It seems like the rules and coverage change every year. Hubby is 61 and has considered early retirement for health reasons, but his "early" pension would just about exactly amount to the monthly cost of our premiums.

The American health-access system is broken. As I've said before, it's equivalent to Third World access in that if you have sufficient money (health insurance) you can get the best whether you live in Des Moines or Delhi. Choose your own doctor? Absolutely.

Without bags of money (adequate insurance), you can "choose" to get sick and die.

Blue Cross execs can go to hell.

Hekate

[Skittles]

2. no way doctors can allow this to happen

because they know the day it does, all hopes of patients telling them the truth is lost - who in hell will open up to a potential snitch?

[cyclezealot]

4. A benefit of being a Blue Cross claims adjuster is being the Monday AM quarterback.

They might let a pre-existing condition pass, while paying your premimums . But, with a little research they will retract their earlier decisions. Monday Morning quarterbacking lets them say such as .... your rheutimism is related to your Melanoma. So sorry, coverages canceled.

[Monk06]

3. First rule of Canadian and other single payer health systems. Pre existing conditons are irrelevent.

Everyone gets the same level of care.