Amazing what some cage rattling can do
- From: PAINxtreme <daver35@xxxxxxxxxxx>
- Date: Mon, 23 Jul 2007 19:53:38 -0700
The mighty Wal-Mart insurance empire has finally given in and is now
paying my back medical bills. If anyone remembers back, they had been
denying all of my claims regarding my spine tumor saying it was pre-
existing, when it was diagnosed 2 weeks after the insurance began. My
doctor wrote them, faxed them and called them to no avail...I provided
them with every piece of info they asked for. Everytime I called them
I got a different story. I called my state's insurance commissioner
and found that they are untouchable on a state level because
WalleyWorld self insures, yet uses Blue Cross as administrator of
their plan. The weirdest part is they have payed the prescriptions the
entire time, just no payments to doctors or hospitals, which as you
can imagine has made it very hard for me to get the care I need. Some
doctors would call them, then demand I pay in full up front or go
home.
About 2 months ago, I decided to be the squeaky wheel. I called my
U.S. Senators office, Pat Roberts (I didnt tell them I wasn't
Republican) And told them of my situation, and that the state govt
could not offer any help and why, and basically my whole story. They
listened, took all my info, and told me they would work with the U.S.
Dept. of Labor. A month ago the Dept of Labor Called me and asked for
all my info from me directly. They told me they would investigate, and
if there was malfesance, they would inform them of their issues, but
would not be able to prosecute them since I wasn't a minority. They
further informed me that from my testimony it seemed to be obvious
that if I took them to Federal Court, it would be an open and shut
case, and if I wanted to pursue it past what their dept could do, I
would have to sue them on my own.
Last week I got a joint letter from Senators Roberts and The Dept. of
Labor Stating their actions and findings, which all pointed to me
being in the right, and what further steps I could take, and how.
Today I began receiving explanation of benefit sheets from Walleyworld
going back a year and a half, showing them paying the amounts the
policy said they should be paying. This looks like just the beginning
of several to come, and about dang time. I honestly believe they try
this with all their employees spouses and dont expect the follow up
that I went thru with this. I can now actually further investigate
surgical options, see more specialists, and perhaps get the scooter I
was trying to get thru a private agency that handles these things. In
any event....The system actually paid off!
I never thought in any world I would be writing a thank you letter to
a republican, especially a Washington one (U.S. Senator) but I have to
doff my hat to the man and his staff for not only acting expeditiously
and effectively, but also very compassionately. Now Im sure they could
easily check and find out I am registered as a democrat (though I
rarely if ever have voted a straight ticket)...whether they did or
not, I have no idea, and it doesn't even matter, I will be sending a
glowingly thankful and respectful letter to let them know my
gratitude, and I wll do my due dilligence on his voting record and
just see if perhaps he may have tilted the scale enough to have gained
my vote...but at the very least he and his staff have gained my
endless respect.
Deus Vobiscum,
-dave
.
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