Dear valued customer, we have rejected your claim...

My insurance uses a prescription benfits program from a company that will remain nameless. (Their intials are M.E.D.C.O.) One of the prescriptions I use comes from a compounding pharmacy, who bills me, not my insurance. (They say it's to keep costs down.) I have to turn around and sumbit a claim to the insurance, who eventually sends me a check for 2/3 of my cost.

This last time I submitted the forms, and mailed them in. At the beginning of the week, I got a letter back that said they denied my claim. It looks like they entered my birthdate in wrong and decided I was not covered. The letter said I could make necessary corrections, then send it in, or I could call my customer service representatiive.

I called them on Monday, the people could not find the claim. (They said they were not the claims department.) I asked about talking to the claims department and was told they didn't have that number. (It's not listed anywhere. I looked.) They told my best bet was to fill out the forms again, and get it right this time. (Can anyone guess my reaction to this answer?)

I called yesterday, and they still couldn't find the pending claim. I asked about talking to the claims department, they said that they could have them call me. I gave my number, they said it would be 24 to 48 working hours before they called back, and hung up. (Sometime between Monday and Thurday of next week...)

I gave up, made the corrections, and mailed the things back in. We'll see if I "got it right this time", or if I have to go through it all again.

Normally in this sort of situation, I would normally go on some sort of tirade about how we're stuck with this company, what options do we have, etc. I would likely do something annoying (to Tara, my coworker, or the company) to make a point. (More on this in the next post, I'll talk about the US Post office.) I don't really want to get to a point where they refuse to cover my prescriptions, so I will be (mostly) quiet. Hopefully I get my reimbursement back before I have to refill the prescription.