It’s bad enough that health insurance companies are ridiculously slow at paying health care providers for the services they are providing that are covered by your health insurance policy.  What’s worse is that they can wreck your credit score at the same time. 

Through personal experience I had one of those preventative internal exams that folks just love to get when they are older.  The procedure was cleared ahead of time by Horizon Blue Cross of New Jersey and all the costs were covered by their policy — they even provided and approval code.  Seems easy enough - doesn’t it. 

So time goes on and I received a statement from Horizon Blue Cross saying  that the procedure was not covered by my policy.  When I called them on the phone, the customer service representative said that the charges were in fact covered by my policy and they would “repost” the claim and it would be paid within the next two weeks.

Well,  after more than a few weeks I received a bill from the company performing the procedure that the fee was not paid by the insurance comany and that the charges were due to thje service provider.  Hmm ….. , this time I got both the provider and Horizon Blue Cross on the phone at the same time and they both understood that the Horizon would be paying charges after re-posting by the service provider.

However, the results we the same as the previous time and the charges were again denied by Horizon Blue Cross.  So again, I contacted Horizon and was told that they would correct the matter and pay the charges.  Horizon just appeared to give only “lip service” as this denied and “refiling” occurred several more times until I ended up with a bill from a debt collector. 

Now I am really getting PO’ed!  This time I contacted both the debt collector and Horizon Blue Cross and told them both what had happened — I moved up the ladder to the primary supervisor who said they would move it to the proper authority who would see that the claim was paid.   I went round and round with Horizon BC and the debt collector for a few more months trying to get this bill paid until finally I ended up with a summons to small claims court.

When this happened, I contacted Horizon Blue Cross Immediately and received the run-around yet again, but was told there was a procedure to make a formal appeal to have the case reviewed by some “higher authority”.  I send a certified letter to the Appeals Dept explaining what had happened.  Within a week the bill was paid by Horizon Blue Cross of NJ.

What they did not do, however, was pay the court costs for the summons that they caused through their inept service.  They also did nothing to help me out with my credit rating and this “collection notice” is now public record and does harm your credit rating.

What really amazes me is how health insurance companies can get away with descriminating against sole proprietors and small business owners.  Why is it that if you work for yourself, you are unable to get group health insurance rates.  In New Jersey, about the only thing a sole proprietor can afford is a lousy HMO policy that basically pays nothing and makes your GP fill out a referral slip every time you have to blow you nose.  For a family of three, HMO rates run approximately $1200 per month for basic 80-20 converage and a $30 c0-pay.  Now, if that same person is an employee of a large company that does the same type of work, that person (or the companny for that matter) would be paying half as much.  The only difference between the two people is for whom the person work.  Work for yourself and pay through the nose or work for a large company and pay alot less.  Now, would someone please explain to me the rational of that? 

What’s even more ridiculous is the fact that the Health Insurance companies have given so much money to support the elections of “our” legislators are allowed to get away with this.  It’s no wonder why a National Health Care System has been talked about for a long time.  However, since legislators do not have to pay for any health insurance costs, it’s no skin off their nose to help their constituents stave off these escalating expenses.

Acacia Catalog at acaciacatalog.com has an easy to use link to remove yourself from receiving junk mail.  Just send an email to customerservice @ acaciacatalog.com as add the particulars from the catalog you received and you will be removed.

It’s amazing how times have changed.  When I was a child, our family doctor actually made house calls.  Now, when you call the doctor’s office to make an appointment, you spend alot of time just trying to get someone to answer the phone.  The  primary reason for this is that your family doctor and their supporting staff no longer work for your benefit — they work for the health insurance companies - gratis.  

What makes this even more galling is the fact that the insurance companies keep raising insurance premiums while claiming that it costs them more and more to operate.  I don’t understand how they put forth such a ridiculous proposition when they dump most of their work on the primary care physicians.  Primary care physicians do not make any money filling out and processing “referrals”.  This is just a ploy by the insurance companies to use these “referals” as and excuse to not pay a claim.  If they actually provided the referals themselves, then they would not be able to deny the claim.  But hey, what do they care,  it costs money to pay the claim — heaven forbid they would have to do that.  Don’t let anyone fool you into thinking this current system is anything more than a fraudulent scam by insurance companies to pass off all their costs onto others while “claiming” higher costs. 

On reason the costs are higher than they should be is due to the amount of reprocessing that occurs with regard to insurance claims.  How many times have you spent hours on the phone with insurance company customer “service” (I use that term lightly)  representatives getting a claim reprocessed because the insurance company did not receive the “correct” information even though the procedure was pre-authorized and processed according to the instructions in the “referral”.  That is where the costs are frivously wasted — your premiums at work.

Just when you thought that the Metal Bat Ban had finally found the trash bin, the three amigos of North Jersey re-introduced the bill for the 2008 session.  So, now it is a “call to arms” again for all those people who actually participate in baseball activities. 

So what did you expect? Did you think these politicians would do anything that is really important, such as making health care insurance affordable to everyday people?  No, that would be too much to ask.  Let’s just waste some more tax payers money claiming to do something “for the good fo the people.”  Their notion of the good of the people has placed the State of New Jersey on the brink of bankruptcy — but let’s not work on this as the state finacial crisis is too hard to tackle — it might actually require them to listen to someone who really knows what they are talking about.

 Enought said, call your local congresman and let’s dump this bill once and for all.  Little League International has already put in rules to restrict bat performance for 2009.

Rich Rodriguez will make one a most fundamental mistake a coach in his position can do tomorrow on New Year’s Day.  He will not be on the sidelines tomorrow when his team, the West Virginia Mountaineers face the Oklahoma Sooner’s in a BCS Bowl game.  Why is this, you ask?  Well, since he has taken a new position with Michigan, he wants to “concentrate on his new position” rather than coach his current team in a prestigious bowl game. 

 Basically,  what he is saying by his actions is that he does not care one bit about the team he put together at WVU.  Wow,  is that a good example for these young men who will move on to regular jobs just like you and I.  What is says is this — do not believe anything you hear from me as I don’t really care about you guys one bit.  When push comes to shove I’ll sell you out and dump you faster than you can call a play in the huddle.

If you are looking to Michigan to play football and get you through college — look somewhere else where you can actually learn about character and team building which will benefit you in later life.  If you want to know how to be a snake oil salesman – well Rich is your man.

Thanks for turning your back on you roots Rich.

I went to the American Express web site to see how to stop getting all of that American Express propoganda in the mail.  They seem to send alot of it.  I had to send an request through the “Contact Us” button but it appears to have done the trick.  After a few days I received an email from Customer service saying they had taken my name off all of the prmotional materials list but it might take a few weeks.  So I will wait and see…. 

Well, this is certainly interesting … I when to lsmagonline.com to try and stop the company from mailing me their magazine.  While the conten might be intresting I can look at their stuff online so I’d like to stop a few trees from being cut down.  Well, they have a contac us button which had on online web form.  When I filled it out it said I did not have permission to use their “formail.php” — what a crock this is.  I will update this post if I get anywhere with them. 

I am sick and tired of getting all of this junk mail.  Every day I get piles of useless requests to buy products or sign up for some services or another.  From my understanding, you can go the Post Office and request that you do not receive junk mail (or any third class mail).  However, once you do that you are cut of from receiving any of this mail at all — grocery fliers, community news, et al.

Every week I get about one grocery bag full of mail that I don’t want.  Now, lets just say that one bag is 10 lbs.  ==> that’s 520 lbs per year of worthless paper that I just recycle.  I wonder how many trees that is? … hmm  

This past season Little League Baseball allowed managers to issue an intentional walk and send the batter to first base without the pitcher throwing at all.  Now, while the intentional walk might be a good game tactic, it does nothing for the development of either the pitcher nor the hitter.

In order to develop mental toughness as either a pitcher or a hitter, both must learn to deal with the stress that is associated with a batter coming to the plate in a key situation.  If an intentional walk is issued, then neither get to “live the moment” when everything is on the line.   In effect, by focusing on winning the game, the manager has denied that unique opportunity to both players.   If you don’t let them work through those situations now while they are young, how will they deal with those issues as they get older.