Blue Cross To Docs: Help Cancel Coverage

Calif. Health Insurer Sends Letters Asking Physicians To Report Pre-Existing Conditions

(CBS/AP)  Citing an effort to hold down costs, health insurance giant Blue Cross wants doctors in California to report conditions it could use to cancel new patients' medical coverage, it was reported Tuesday.

The state's largest for-profit health insurer is sending physicians copies of health insurance applications filled out by new patients, along with a letter advising them that the company has a right to drop members who fail to disclose "material medical history," the Los Angeles Times reported on its Web site.

"Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately," according to the letter obtained by the newspaper.

One of the conditions noted in the letter that could force a new patient to be dropped by Blue Cross - pre-existing pregnancies.

WellPoint Inc., the Indianapolis-based company that operates Blue Cross of California, said it was sending out the letters in an effort to keep costs at a minimum.

"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," WellPoint spokeswoman Shannon Troughton said in an e-mail to the newspaper.

"Blue Cross feels it is our responsibility to assure all records are accurate and up to date for HMO providers," she said. "We send these letters to identify members early on in the process who may not have been honest in their application."

Troughton added doctors are not required, but rather can volunteer, patients' information to Blue Cross.

Doctors were unhappy about the letter, warning that some patients might hide any medical history that could affect their prospects of receiving health insurance.

"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," said Dr. Richard Frankenstein, president of the California Medical Association.

Blue Cross is one of several California insurers that have been criticized for issuing policies without checking applications and then canceling coverage after individuals incur major medical costs. The practice of canceling coverage is under scrutiny by state regulators, lawmakers and the courts.

Patients in a raft of lawsuits accuse the insurers of canceling coverage over honest mistakes and minor inconsistencies on applications that they contend are purposely confusing. Victims of cancer and other serious medical problems often are unable to get new coverage once their insurance has been rescinded, reports the Los Angeles Times.

Troughton said the request of doctors has been in place for several years and Blue Cross has not received any complaints about it. The health insurance company doesn't always cancel the policies of patients with discrepancies in their applications and occasionally offers them another plan, she said.

Lynne Randolph, a spokeswoman for the state Department of Managed Health Care, said the agency would review the letter. Blue Cross is fighting a $1 million fine the department imposed in March over alleged systemic problems the agency identified in the way the company rescinds coverage.

"They are playing a game of 'gotcha' where they are trying to use their doctors against their patients' health interests," said Anthony Wright, executive director of HealthAccess California, a healthcare advocacy organization. "That's about as ugly as it gets."

[crusherking]

Where is the patient/doctor confidentialty here? Isn''t a doctor bound by this to NOT disclose this info to anyone without the patients consent? Seems BC/BS needs to review the laws before making their policies.

[mcvet]

Well when you have the WORST health Care system in the civilized world, a system costing MORE per covered person and delievering less than any of those nations, what can you expect. It seems the fascist plan to "fix" the health care system is working out just fine... for the Insurance Companies!! Sieg Heil Y''all and don''t get sick!!

[sdcjd1]

We desperately need healthcare reform. Hopefully voters will pay attention to this important issue next election.

[missingamerica]

"...needs to review the laws before making their policies."

Posted by crusherking at 02:43 PM : Feb 12, 2008

Another example of "too much regulation" - letting laws interfere with profits.

[kennergirl]

Insurance companies make me sick.

I will be dropping Blue Cross Blue Shield as soon as I have replacement coverage.

[antoniof123]

Another example of "too much regulation" - letting laws interfere with profits.

Posted by ibsteve2u at 03:05 PM : Feb 12, 2008

Are you an idiot this is because of deregulation not regulation. It was illegal to drop someone if they attempted to be honest. But now these misfits have idiots beleiving that this is in there best intrest.

Quit listening to the RNC and raido shock jocks they LIE. If you haven''t figured it out yet.

God there is one born every minute or in this countries case 30 percent born and breeding.

[retiredusaf3]

LOL Isn''t this one of the companies that Hilliay wants covering you???

[irliberal]

A fine example of a capitalist system of health coverage that Hillary proposes to fix.

This profit grubbing and money grabbing and disregard for doctor-patient confidentiality are all results of the current private health care for-profit industry.

Time for a change.

[magoo2u1]

AND which of you idiots doesn''t understand that when these rejected people file for bankruptcy and the doctors claim the losses on their taxes - THE TAXPAYER GETS THE BILL ??? The hospital will get paid by the government and the inflated bill, not what the INS co. would have paid. EXample : my daughter had pneumonia, Total bill? $2200.00 What did everyone accept from Ins ? $450. The taxpayer will suck up the $2200 when these people can''t pay. Insurance companies and Republicans, like the police, ARE NOT YOUR FRIENDS.

[talkingham]

In case you haven''t figured the insurance companies already ruin healthcare in this country. They steal every penny they can from your paycheck and when you need them they nickle and dime you to death and find every excuse possible not to pay you. I''d be better off sticking my payroll deduction in a matress.

Allstate- the good hands people, their logo should show those hands strangling you by the neck. These companies and their millionaire executives and paid pushers the doctors are driving the cost of healthcare thorugh the roof, not the consumer who pays their bills!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[wango2007-2009]

WellPoint Inc., the Indianapolis-based company that operates Blue Cross of California, said it was sending out the letters in an effort to keep costs at a minimum.
---------------------------

What a joke. They are not interested in "cutting costs" to help anyone... the only want to increase profits for stockholders.

WellPoint Inc/Blue Cross of California is a predatory monster.

Trying to get doctors to help them profit from people''s pain is just pure evil.

[rmagee3]

Insurance companies are a business and believe me they have no heart. They do what is in their best financial interest and saving your life is not in their best interest. Once you cost them more than you could ever bring in, it''s over!! I have a 4 year old grandaughter that has a genetic disorder that she can die from if it is not properly treated. She was denied coverage by every insurance company we approached until the State of Arizona got involved. That policy cost my kids $1000.00 a month and covered only illness and injury that could not be related to her disorder. The government has to do something or eventually no one who has ever been sick or in the hospital will be able to get and keep coverage. I am a Republican and I don''t advocate the government paying for everyone to be covered but they have to do what is in the interest of all citizens. If you are a UNited States Citizen, paying taxes and living here legally, you should have some recourse to get coverage.

[iceman_1960]

"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," said Dr. Richard Frankenstein.

Dr. Frankenstein has really put his finger on it.

Blue Cross is a monster run amok.

[docpeter-2009]

Considering the CEO(s) of the big ICs make in the $M annual salary range and it is the PATIENT/CUSTOMER who is paying for their salary, I guess the CEO has his eye on a second home as well as a nice diamond and Porsche for his wife''s and kid''s christmas. God help him, he can''t afford both this year if he has to pay for someone else getting sick. Three people they need to run our of Washington DC: big pharma, insurance, and oil companies. These folks are raping all of the rest of us.

[docpeter-2009]

RE: talkingham stated, "Allstate- the good hands people, their logo should show those hands strangling you by the neck." Sorry to disagree with you here, but you are a little too far north of where they have their hands. Think much further down South. This goes for all of the insurance companies.

[hawksprings]

::"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," said Dr. Richard Frankenstein.
Dr. Frankenstein has really put his finger on it.
Blue Cross is a monster run amok.::"
Posted by Iceman_1960

Excuse me people, but if someone LIES on their application, then the insurance company should have every right to cancel their coverage.

You need to stop and think about that before you fly off the handle and crucify Blue Cross.

Just because Bill Clinton gets away with lying doesn''t mean everyone should.

[bb19631]

This is the kind of bulllshit, Michael Moore was talking about in his documentary "Sicko". Watch it , you may learn something. What ever happened to Dr.-patient confidentiality? These insurance companies are making me sick. We are getting poorer, they are getting richer by billions of dollars. The insurance companies have monthly quotas, they have to meet by turning down people, to line their own fat wallets.

[au_fait]

MCVET, you are a moron. Do you really believe that everything in the world is Bush''s fault. The insurance industry has been going downhill sicne the 90''s, if not before that. Let me guess that was Bush senior''s fault. As for us having the worst medical care, you are mistaken. If you have the ability to pay, it is a great system. What sucks in our system, is the lawyers who are ambulance chasers which have increased the costs to doctors, who will pass it on (as in the case with all buisinesses). Let see, oh and free insurance to illegal immigrants, which causes an increase to the doctors as well as the tax payers. Not that insurance companies do not suck, as in many cases they do. But the quality of care you can recieve far outweighs what is available around the world.

[iceman_1960]

"Excuse me people, but if someone LIES on their application, then the insurance company should have every right to cancel their coverage."
- Posted by hawksprings at 04:13 PM : Feb 12, 2008

Excuse me, but I was having a little fun with the good physician"s name: Dr. Frankenstein.

Now don"t you feel a little dumb ?

[crusherking]

McVet= obviously off his rocker and blinded by his hate.

Rp44_63= Delusional if you think that Socialist healthcare is the way to go. Check out the healthcare system in Canada eh.. It sucks!!! And to top it off. Check out how much tax they pay to maintain that miserable healthcare system. It sucks too. The idea of Universal Healthcare is wonderful, but the reality is that it will only drag down the system as a whole. Please research this issue before you support something that will completely destroy the level of healthcare we have now.

[sharncedar]

You fools - you aren''t going to get squat. The government from top to bottom talks all day about cutting social benefits to pay for the wars, and that includes hillary "devil-worshiper" Clinton who has already criticized Social Security and the other "entitlements".

How could you even imagine that you will get free health care? The talk amonst the evil leaders is that Americans are too lazy, too selfish, too expensive and the whole problem with the economy is that they get oo many entitlements and benefits.

Hillary and her satainc friend are going to cut your benefits, not increase them. It''s liek the fools who didn''t bother to read Mein Kampf - Hillary states right out she is going to cut benefits, just listne to her, hear what she says, not what you hope she says. Her "health care plan" requires you to buy insurance, it doesn''t give anything to anyone.

[tejasdemo]

Go to hell Blue Cross

[jwrhea]

Be careful of what you wish for. Any national healthcare coverage must be paid for. And you cant get money from the unemployed. They will deduct it from the paychecks of anyone who works. (hillary is actually promoting this idea) So if you can afford 40 to 50 bucks a week from your paycheck to pay for national health care your far better off than I.

[iceman_1960]

My "Basic Blue" Blue Cross premiums have been increased 12% a year in the past two years, although my health is very good and I"ve only filed one claim: for x-rays related to a broken finger.

[hawksprings]

The moral of this story is "Don''t Lie on your health insurance application."

Or maybe Hillary will make a law saying that you can lie on your app with no consequences.

Besides, when you apply for health insurance, many companies request doctors'' records, so they''ll catch you lying when you apply.

[wango2007-2009]

Posted by hawksprings

Excuse me people, but if someone LIES on their application, then the insurance company should have every right to cancel their coverage.

-----------------------

hawksprings, You have missed the point ENTIRELY.

WellPoint Inc / Blue Cross of California want to turn doctors in to cops or informers. That''s just evil. Insurance companies hould not give coverage until they themsleves have done an investigation.

Insurance companies have long used so-called "pre-exisitng conditions" to deny payments and kill off customer/patients that would hurt their profits.

No one can defend WellPoint Inc/ Blue Cross of California. No one should. They are a menance to humanity as are all other such companies that profit from pain and suffering.

[iceman_1960]

I thought the ethics physicians" confidentiality would prevent them from "ratting" their patients out to their insurers.

I guess not.

Blue Cross should also appeal to all the Catholic priests in California, to report if anybody has admitted in the confessional that they lied on their insurance forms.

[iceman_1960]

The ethics OF...

"I thought the ethics of physicians" confidentiality would prevent them from "ratting" their patients out to their insurers."

[hawksprings]

"I thought the ethics of physicians" confidentiality would prevent them from "ratting" their patients out to their insurers."
Posted by Iceman_1960

When you fill out an insurance application, you are agreeing to release your doctor''s records to the insurnace company. It''s in that big paragraph right above where you sign.

[aeasus]

If there is one thing I would like to see changed is pre-existing disqualifications. Let me explain.

My neighbor worked for NCR and was laid-off. Some time later he landed a job at Intel. During his 90 day prebenefit employment he complained of abdominal pain but was afraid of it being deemed pre-existing before his medical kicked in. I couldn''t get him to see a doctor. He died of appendicitus complications weeks later. This was a sad way to lose a friend.
Gary Phillips R.I.P.

[hawksprings]

Wango2007,

They''re not doing anything they haven''t done for years.

If you buy health insurance, and then soon after turn in a claim for, let''s say ulcers, the insurance company is going to say, "Hmm, I wonder if they had ulcers before they bought our insurance?" And they will request the doctor''s records and see if it was a pre-existing condition that you didn''t reveal on the app.

There''s nothing new about this.

I repeat: The Moral of this story is DON''T LIE ON YOUR APPLICATION!

[hawksprings]

"My neighbor worked for NCR and was laid-off. Some time later he landed a job at Intel. During his 90 day prebenefit employment he complained of abdominal pain but was afraid of it being deemed pre-existing before his medical kicked in. I couldn''''t get him to see a doctor. He died of appendicitus complications weeks later. This was a sad way to lose a friend."
Gary Phillips R.I.P.
Posted by aeasus

That is very sad.

[rf35]

Wake up people! Blue Cross is an insurance COMPANY. COMPANIES exist to make the most money they possibly can. That is not evil, it is capitalism. If you are willing to allow COMPANIES to control your health care, this is what you get.
"One of the conditions noted in the letter that could force a new patient to be dropped by Blue Cross - pre-existing pregnancies."
This is so wrong on so many levels, yet it is the COMPANY''S right to make money any way it can. Morality and ethics have no place in corporate business. When Americans did nothing to stop COMPANIES from taking over their health care, we asked for this.

P.S. Dr. Richard Frankenstein...are you sh*ttin'' me?

[crusherking]

Well Rp44-63, I did compare other health systems and the one you are supporting is a government provided healthcare system just as they have in Canada. Don''t see how its any different. Sure if you present a plan for privatized, personal healthcare for life that does not require anyone to sign up for it or force me to pay 1/2 my salary in taxes, i''d be interested in reviewing. As of now, I have not seen anyone propose anything even close. I have seen what Billary wants to do, Garnish your wages to force you to subscribe to her socialist healthcare system and pay for it with tax increases. That is WRONG! So if I am missing something here, like a plan you have proposed or support that is privatized, please elaborate.

SBBM And just FYI, born, raised and still American.

[bobnjersey]

[If there is one thing I would like to see changed is pre-existing disqualifications. Let me explain ...]
[Posted by aeasus at 05:18 PM : Feb 12, 2008]

in most cases ... it''s only pre-existing because there''s no continuity in medical coverage across employers ... which there should be.

the absurd cost of medical insurance ... and the tie to the employer will ultimately lead to all employees to paying their own way ... or all good paying jobs will be outsourced because american companies will no longer be able to compete.

[crusherking]

rp44_63 wrote"Dear "crusherking", you poor pathetic moron. You''''ve been suckered by republicans"

Really? Thats why I did the research. Thats why I understand the problems with Billary''s socialist plan. I think you are the one being blinded by and lied to by the Liberalist socialist party called the democrats. For example.

If you don''t accept the plan.. You''re on it anyway and she''ll garnish your wages.
Taxes will DRAMATICALLY increase. Do the math.
Doctors won''t make more than 70k? WOW! Glad I decided against a career in medicine!!!

Cradle to grave?? Yeah.It''ll tax you to death!!! And if it doesn''t, how competent and motivated do you think your surgeon''s going to being knowing that he only gets 70k? Yeah.. I''m the moron because I actually know what I am talking about..

[wango2007-2009]

There''''s nothing new about this.

I repeat: The Moral of this story is DON''''T LIE ON YOUR APPLICATION!

-----------------------

hawksprings, I think you must work for the insurance industry, because you couldn''t just be a moralists.

1. There have been many cases where the insurance companies have constructed forms that make it IMPOSSIBLE to report what they later wish to know when they want to cancel you.

2. Insurance agents COMMONLY say, "oh, the insurance company isn''t concerned about that" when you ask them about some issue. They only want the commission, not provide help in completing the complex forms.

3. Health insurance companies have a track record off TWISTING information put on forms if they want to cancel you.

Is lying immoral... if it is lying, yes. That''s why it is THEIR responsibly to check the facts BEFORE they issue a policy. Only SLEAZY insurance companies, like Blue Cross of Cal would enlist doctors as snitches. THAT is immoral. Denying coverage to increase corporate profits is also immoral.

[iceman_1960]

"When you fill out an insurance application, you are agreeing to release your doctor''''s records to the insurnace company. It''''s in that big paragraph right above where you sign."
- Posted by hawksprings at 05:17 PM : Feb 12, 2008

I knew there was some subtle catch there someplace.

But we"re talking about doctors going out of their way to call up the insurer and report things.

When you are dealing with doctors and patients, sometimes humane considerations occur that bend the written rules.

My brother was being treated for an asthma-like condition that later turned out to be just a little cat allergy. His doctor knew that he was switching insurers, so he told him he would not list this as asthma on the records, just a seasonal allergy -- which is close to what it turned out to be.

Human patients are more than numbers on an accountant"s balance sheet.

[bobnjersey]

[Wake up people! Blue Cross is an insurance COMPANY. COMPANIES exist to make the most money they possibly can. That is not evil, it is capitalism. If you are willing to allow COMPANIES to control your health care, this is what you get.]
[Posted by rf35 at 05:26 PM : Feb 12, 2008]

capitalism in the health business yields the evil ... cause they don''t care about health ... just money. the only problem is ... they''re in the bad health mitigation business ... or at least that''s what their premium payers think.

of course ... since the ''more money'' comes from actually not providing mitigation to health problems ... there''s just a little something wrong w/ the model.

[iceman_1960]

Do what you can to stay healthy, also.

Exercise, eat right, don"t have any bad health habits like smoking.

Better you don"t need to throw yourself on the tender mercy of these sharks in the first place.

You can improve the odds.

[byeneocons]

Blue Cross is taking an amoral approach to rising costs. Perhaps they should look more closely at their CEO''s salaries and bonuses, or the fact hospitals can charge patients up to fifty dollars for an aspirin. Playing witch hunt with applicants is not the answer, and doctors are not about to risk lawsuits by narcing on patients.

[irliberal]

A fine example of a capitalist system of health coverage that Hillary proposes to fix.

This profit grubbing and money grabbing and disregard for doctor-patient confidentiality are all results of the current private health care for-profit industry.

Time for a change.

[wango2007-2009]

rf35- That is not evil, it is capitalism.

-----------------

That just means Capitalism is a killing machine, whether they''re are making weapons to kill in places like Iraq or killing people here at home as the result of the profiteering Health Insurance industry.

America is a sick, sick country. We are totally corrupt if we have come to the place where we can say, "That is not evil, it is capitalism" as if our horrible system was okay.

[wango2007-2009]

IRLiberal - A fine example of a capitalist system of health coverage that Hillary proposes to fix.

This profit grubbing and money grabbing and disregard for doctor-patient confidentiality are all results of the current private health care for-profit industry.

Time for a change.
-------------------

I am a Conservative, and I couldn''t agree with you more. Healthcare is NOT a liberal v. Conservative matter. Providing universal healthcare though taxes is a legitimate function of goverment.

[toolmangler-2009]

In 2004 I had a compete physical including an EKG and stress test, the very next weekend I had a severe heart attack and arrested twice in the ER. If I had been a customer of Blue Cross I would have been denied coverage because of a "pre-existing condition". I was told this by a former Rep of Blue Cross. improving profit margin is one thing, robbing sick people is another. If you wish to improve your profit margin, do it by pre-treating dangerous conditions before trouble developes. It is well known that bad teeth causes bad health, Bad eyes and ears promote dangerous living habits Like stepping into unseen traffic or any number of other things that could happen. Fix them. A 200 dollar pair of Glasses is less expensive than $50,000 for a hospital stay, and a prosthetic limb to replace the one sheared off in an accident. (pay me now, or PAY me later)

[irliberal]

I am a Conservative, and I couldn''''t agree with you more. Healthcare is NOT a liberal v. Conservative matter. Providing universal healthcare though taxes is a legitimate function of goverment.


Posted by Wango2007 at 05:51 PM

Well... since Obama and Hillary and the republican candidates are NOT, that kind of makes it a conservative vs liberal issue don''t you think?

Regardless of how you think of it in the vaults of your own mind, it is a necessary thing, at least on that we agree.

[irliberal]

Err, that should have read Obama and Hillary are FOR universal health care and the republicans are NOT. Need to pay attention to what I''m typing. :)

[uscitizenvet]

I''ve had BC/BS insurance for over 40 years and "never" had a problem with them. I''m currently on Medicare with a BC/BS supplement and still continue to get excellent service. If a person "LIES" on their insurance application, why shouldn''t they be dropped? If you lie on any kind of application, you should not get the same service as the honest people!

[rowdytexan2]

BC/BS has been almost totally useless to me off and on since 1963. Currently I am having to travel 271 miles to see a cardio doctor because they will not move my coverage to this county as I listed my permanent address when I took out the policy with my retirement package!

They''re TOTAL CROOKS!