BCBSNC Round-Robin / Pass the Buck : Mismanagement by their 'Network' re: Screening Colonoscopies in NC

May 20, 2008

Dear Jonathan Givens (supervisor, Customer Service: 919 765 3951) :

I appreciated you calling me back today and spending time on the phone re: my query associated with non-availability of screening colonoscopies in western NC.

As was revealed by earlier conversations w/ supervisors at BCBCNS, the closest screening colonoscopies----of any sort--- be they office-based or clinic-based-----is in Boone, NC and Charlotte, NC.

Additionally, as you apparently scanned your provider information while we talked on the phone, you acknowledged that there seemed to be a general lack of this service across NC.

What perplexes me is that I have brought up this topic w/ over a dozen individuals within BCBSNC----and everyone appears to be surprised at the non-availability of screening colonoscopies in NC.

Does the left hand know what the right is doing at BCBSNC----or has the administration of BCBSNC created a set response for those wanting to choose health over possible disease, disease which is entirely addressable in its early form?

I appreciated, Mr. Givens, you stating that you believe that the problem is with the ‘BCBSNC Network’ as pertaining to lack of providers. I would like to suggest that BCBSNC has known about this problem for some time now-----at least the past 9 months that I have been following up on this matter.

I wrote the BCBSNC CEO in October, 2007 and all I received back was a letter indicating that the ‘problem’ was with the providers.

Sorry: its BCBSNC’s problem. And until they own up to this, it’s my problem.

And as I commented, I would be elated if you came up w/ a solution.

However, all I have gotten from BCBSNC for the past 9 months-----as associated with various chains of supervisors----and the ‘Government Affairs’ supervisor, Nell Boone, is a passing of the buck, with no one willing to tackle the problem for BCBSNC’s ‘state plan’ insured (you indicated to me that PPO---which I have----and ‘state plan’ is one and the same thing).

While Nell Boone appeared curious about my speculation that gastroenterologists have evolved to the place where they believe that ‘clinic-based’ screening colonoscopies are to be preferred over the office-based, non-medicated/ stick it up your arse, treatment, apparently BCBSNC does not believe that their insured should be accorded treatment which has been deemed medically appropriate.

There are literally thousands of BCBSNC insured who have no access to screening colonoscopies, medicated or non-medicated-----indicated by the American Cancer Society and gastroenterologists----as a critically important screen. With over 2 million PPO insured as per your website, I believe that this would translate into literally hundred of thousands of consumers w/o this important service.

I am looking forward to you finding a gastroenterologist----someone within a reasonable travel time----not 2-3 hours as is currently available----in western NC.

You owe it to your insured. Can we not move to a more reasonable manner of procuring health care which---in the long run----costs less, assures consumer satisfaction, and increases the quality of life of BCBSNC consumers?

Marsha V. Hammond, PhD: ‘insured’ by BCBSNC