Sunday, February 21, 2010

Group Health: Airing of Grievances

I mentioned a while back that I had some new grievances against Group Health and was waiting for an appropriate time to air them (alas Festivus is past, so this will have to be done out of season).

These grievances have nothing to do with my current medical care, with which I am quite satisfied right now (how do you argue with success?--and the medical staff really does seem to be quite caring) but everything to do with their administrative side. And like Gaul, Group Health's administrative problems for me, are divided into three parts.

1. The first rant is that Group Health is doing no better than any other insurance company in containing health costs, and perhaps far worse. Item: for the first time in my 27 year history as a government employee covered by Group Health, I now have to pay a $250/person deductible. Group Health has never had this deductible before and I was not informed of this new cost to me during the state employees' "open season" last November, where we can change our health insurance coverage. I've checked with friends and co workers who are Group Health members, most of whom are very careful readers of the policy descriptions each year, and none of them were aware of this new cost. For families it is even worse: $750 in deductible. Now couple that with a 250% rise in co pay costs (each office visit is now $25 when it was $10 last year) and a corresponding increase in prescription drug costs, together with increases in the premiums that I must pay and my medical costs have skyrocketed far beyond even what I planned for back in September when I was first diagnosed.

2. The second rant has to do with the fact that Group Health's billing system crashed last fall and it has really screwed up how I pay for my office visits and prescriptions. It used to be a pay as you go system, where I could write a check or use my debit card to pay for these services at the time I used them. But Group Health's billing system, which was being changed in Sept/Oct last year, crashed on them and now I have to wait to get a monthly bill for everything all at once. Talk about sticker shock!! It was far easier to pay for these expenses as they were incurred because I could better integrate the costs into my monthly budget. I am not wealthy here. I am a state employee with a mortgage and one kid still attending college, so I don't have a lot of stretch to cover it otherwise. And it has been 5 months now and they still have not fixed it. How unprofessional is that?

3. The third rant came last week in a letter to me from Group Health dated February 15, 2010. According to this letter, sometime in January Group Health was contacted by the Seattle police because a temporary worker at GH had taken my personal information, such as my name, address, Social Security number, date of birth, Group Health number, health plan enrollment information and my medical information. I was informed that this former GH temporary employee might be using this information for fraudulent purposes. Really?

Perhaps that explains the letter I received on February 1, 2010, from HSBC (formerly Household Bank--a credit servicing agency for a number of retailers) that a change of address on my Best Buy account had been processed by them. I contacted Best Buy about this right before I left for Hawaii, and learned that according to this change of application, I had moved to 2814 SW 107th Street in Seattle--Arbor Heights to be exact. News to me.

In an attempt to reassure me, Group Health stated that "As a precaution, we have partnered with Experian to provide you with a full year of Triple Alert credit monitoring membership without cost to you (Group Health's emphasis)." This was through Experian, one of the three national credit reporting agencies. I was urged to contact Experian's Triple Alert website and enroll using the GH activation code, which was provided in the letter. So I did that. After enrolling using my GH activation code, I was directed to a site that asked if I wanted to get copies of my credit reports. When I clicked on the "yes" button, the next screen told me that I would have to pay $19.95 for that privilege. Now this is where I began to have steam coming out of my nostrils.

To begin with, as you may recall, Group Health represented in their letter to me that this Triple Alert program was to be "without cost to [me]". And to end with, the Fair Credit Reporting Act, which is a federal law codified at 15 U.S.C. § 1681, gives me and all consumers the right to a free credit report from each of the three credit reporting EVERY 12 MONTHS! Who does Group Health and/or Experian think they are dealing with here? As a former Consumer Protection attorney, I know this kind of stuff or at least can follow up on vague suspicions through diligent legal research. Perhaps they are counting on other members who just fell off the turnip truck.

But, as you can see, all of these non disclosures and deceptions have created a stronger negative perception of the Group Health administration than I have ever had before. They are doing themselves no favors by these actions. I would hope that someone within the organization can step in and stop this slide to mediocrity and mendacity. But I am not sure how to get through to them.

Maybe a post on Daily Kos might help.


Anonymous said...

First, congratulations on your latest report. Re: your insurance follies, we were informed a couple of years ago that our relevant numbers (ssn, etc.) were inadvertently released and we would be compensated by a free one year membership in Experian, et. al., to receive any reports of possible use of our credit info by any bad guys. Fortunately, it didn't happen, but this hardly seemed a fair way to compensate us for their loose control of our information. Payment for any financial cost to us in such an event would seem the least they could do. I hope we soon get national insurance.

Anonymous said...

Hi Regina,
Say, when I had my gall bladder removed at Ballard Swedish in August of 2006, my identity was stolen by a gal in admin. When I came home, I started getting calls from the fraud depts. of various credit card companies. I called the police and they made a report. Did nothing. At first I didn't know how my ID was stolen but one credit card co. told me the address that was used to apply for a card(I wrote that down). Then another company asked me if my name was Rashawn Noble. Now i had her name and address. I googled it.Ended up on the perp's MY SPACE homepage. She mentions on her My Space page that she works at Swedish hospital as a surgery technician. So, I called security at Ballard Swedish and told them they had a problem and they should fix it or the police would be calling next. Swedish fired the gal. Swedish gave me membership in Kroll Securities in Kentucky. They were helpful in straightening out the mess. I got 7 years of protection for all 3 credit companies; Experian, and the other two. The Seattle Police called me and picked my brain but in the long run did absolutely nothing because Rashawn had only swindled me for a couple thousand dollars. The bulk of her charges were to "Victoria's Secret." You know me, I wouldn't have been interested in that company even if I was still young. Vic's Secret was the nastiest about forgiving the debt that Rashawn had incurred. Sorry to hear about your situation. I also had VA data stolen. David had Hewlett Packard data stolen. What a world!!!!!!! Your friend,Kathleen