Marsha V. Hammond, PhD e mail: firstname.lastname@example.org cell: 404 964 5338 BCBSNC PPO policy-holder NC Department of Insurance case number: : 2008-10-01135
December 11, 2008
Hello NC Department of Insurance, External Review Department: (email@example.com,firstname.lastname@example.org,email@example.com,firstname.lastname@example.org)
Can you find out why the below is taking place and how I can get to a clinic based screening colonoscopy----which is what gastroenterologists offer? They cost about $1200.00, are to be had, unless one has polyps, every 10 years, are preventive, and BCBSNC will not cover a clinic based screening colonoscopy.
Specifically, I, my husband, and 14 yr old son, all in good health, have BCBSNC PPO. It is time for me to have a screening colonoscopy. I have bought my complaint to someone in the Department of Insurance, specifically, Doris Edwine, tel 919 807 6773. I wrote her a letter outlining these matters. She was presented by BCBSNC, I guess, w/ a list of gastroenterologists in western NC---none of whom will do a screening colonoscopy as a office visit----which is what BCBSNC will pay for. And so there are no screening colonoscopies available tho BCBSNC is (appropriately) sending me a letter stating that I should have one!
Can someone help me w/ this? I have asked my representative, Susan Fisher. I get no reply. The Department of Insurance has assigned me a number but nothing is taken care of.
I have been investigating this for over a year now.
Imagine all the people w/ these policies who will come down w/ colon cancer just in time for Medicare to pick it up. It will have been/ could have been so prevented by early detection.
Pass this e mail to any pertinent party. You can see a compendium of my attempts to get this service here where you can see that I have repeatedly contacted BCBSNC government liasons. http://madamedefarge2scutinizingbcbsnc.blogspot.com/
Sincerely, Marsha V. Hammond, PhD
This is what I have sent to my representative, Susan Fisher:
Monday, November 24, 2008
Dear Rep Fisher: Insurance Commissioner’s office cannot get past lies of BCBSNC PPO re: non-availability of colonoscopies in western NC
Letter to Representative Susan Fisher: Fisherla@ncleg.net
Marsha V. Hammond, PhD: Clinical Licensed Psychologist, Asheville/ Waynesville, NC
e mail: email@example.com cell: 404 964 5338
RE: NC Department of INsurance cannot see past the song & dance of BCBSNC re: screening colonoscopies
November 24, 2008
Dear Susan Fisher, my NC House of Representatives person:
There are still no screening colonoscopies for citizens of western NC w/ BCBSNC insurance plans….2.5 million of us across the state. Most lately, the NC Department of Insurance has fallen for their song and dance which seems to be associated with coverage, but in fact, is not.
To make it all the more hilarious, BCBSNC just sent me a letter suggesting that I have a screening colonoscopy!
I talked to the insurance commissioner’s office, specifically, Doris Edwine, tel 919 807 6773. I wrote her a letter.
BCBSNC simply sent her a list of the gastroenterologists in Buncombe county. As I have done before, I called them. They told me what they have told me before, namely that their practices will not do office based screening colonoscopies. They do only clinic based screening colonoscopies…like they told me a year ago.
I have been researching this for a year now (please see the blog which does not reflect the six months prior to the first post in June, 2008). Nothing has changed. I would like to know what the NC State Legislature which oversees BCBSNC is going to do about this.
BCBSNC PPO will not pay for clinic based screening colonoscopies and the gastroenterologists will not do the office based ones, I assume, as associated w/ the risk of having a patient move around on the table and then puncturing their colon which means that —literally—-you better have created your will cause you’re a dead person.
My file number: 2008-10-01135.
It would be useful to have my NC State Representative check on this matter, I believe.
Marsha V. Hammond, PhD