What are “Special Services”?
November 22, 2011 in Hospital Bills, Insurance Bills, Member Stories
I do not understand how insurance companies can ask me, as a patient, to help keep costs in line by making sure I am getting tests and treatments directly related to my problems but then send me Claim Summaries that tell me nothing.
I was in PACU (ICU) for three days from surgery until release because there was no bed available on the floor, but reviewing the summary sent by the insurance company with a list of “Special Services” tells me what? Nothing!
The also recently sent me a similar Claim Summary for three days from last summer while I was undergoing radiation treatment for Prostate Cancer. That summary was also completely useless in telling me what the payments were for listing Lab work several times, Medical Treatment and X-Ray once each and more “Special Services” several times.
They seriously need to come up with a better way if they want patients to take part in the responsibility for treatment. I know that if I was presented these Claims Summaries as a bill to be paid I would refuse.
Martha Bebinger said on November 23, 2011
Dave – I asked Blue Cross for a comment – this is from spokesman Jay McQuaide:
“First, we recognize that we need to do a better job simplifying the experience for the member and making it easier for members to understand the cost of their care. This is a major priority for the company as we advance our affordability agenda. We recognize that a key part of moderating cost increases is by engaging the member and assisting them with finding high-quality, lower cost health care.
In 2012, we will be introducing a redesigned explanation of benefits (EOB) that will be a major improvement over what we have today and it will present claims/cost information in a much simpler, easy-to-understand format. It will help explain the cost of the services, the discounts members received through BCBSMA, the cost sharing they have via deductibles and copays, etc.”