<p>My wife has now had cataract surgery on both eyes and things are going well. </p>
<p>Between the doctor’s office and Anthem, there was a mix up and my wife had problems getting prescrptions filled. </p>
<p>The doctor’s office gave my wife free samples instead.</p>
<p>Yay, dstark! Hope her recovery goes well!</p>
<p>Thanks…so far so good.</p>
<p>dstark, glad to hear your wife is doing well! I have to have cataract surgery, also. My ophthalmologist told me 6 years ago I would need the surgery in about 5 years - but at my last check up a few months ago he said they haven’t gottn any worse so I am on hold for now. </p>
<p>I can’t understand why all the difficulty in being properly billed/coded between doctor’s, hospitals and insurance companies. It is not like they haven’t been in the business for years and years - but there are always problems no matter the service provider or insurance company. I was just on the phone with my mom, who has both Medicare and supplemental through NYS Retired Teachers and my dad through the company he owned policy, and there is never not a problem. What do people do who are elderly and not capable of dealing with with all these different entities - or have children who are too busy with their own stuff to deal with all of it? I bet a lot of them just pay whatever it says they owe. </p>
<p>Probably. My wife is very happy with the results. Somebody told me that cataract surgery has the highest satisfaction rate compared to any surgery. My wife hasn’t seen this well in years and years. She sees in color. 
</p>
<p>May not need any glasses. She went the multi focal route. She will know more in about a week or two. One eye was done yesterday. The other last week. The actual operations were 5 to 10 minutes.</p>
<p>Her last doctor visit is next week. Makes her more comfortable that she will be done with the opthamologist next week because in 2015, we will have a different plan and Anthem will be history for us. The doctor will no longer be in our plan. </p>
<p>I was reading that Anthem was really optimistic about 2015. I don’t know. I hear complaints about Anthem. </p>
<p>Is there an insurance company on the planet that doesn’t have complaints? </p>
<p>My insurance company is excellent but there are still always some problems. Last year it took forever for me to get the hospital and the insurance company to fix a very minor problem - the hospital was billing my PT as in hospital so it was getting rejected by the insurance division who handles in patient billing because I wasn’t approved for that. I was only approved for out patient PT, which was fine as that is what I had and the hospital needed to submit to the correct ins. division. It was an endless round of calls for months as every bill for all six sessions was billed incorrectly. I finally told the hospital billing office (a different hospital then the debt collection one) if they wanted to get paid they better figure it out with the ins. co. as I was not paying the bill. </p>
<p>There are complaints and then there are complaints. :)</p>
<p>Are you saying my problems aren’t complaint worthy? 
</p>
<p>Emilybee, No. </p>
<p>I was answering your first question in post 15685. You know, the question about insurance companies. </p>
<p>Some complaints about insurance companies end up in lawsuits.
Some insurance companies are not doing a good job.</p>
<p>You can smile. </p>
<p>Ok. </p>
<p>TBH, I am sure, compared to others, my problems are pretty insignificant as problems with insurance carriers/service providers go. I do worry about people who aren’t very knowledgeable getting screwed because they just don’t know better or have no idea how to get their complaint/problem heard by the person/people who can do something about it. It’s not necessarily just insurance companies, either. It seems every consumer business sector is pretty bad on the customer service scale. </p>
<p>True. </p>
<p>Some of the medical offices have also been pretty bad.</p>
<p>Your problems sucked. They should not have occured. </p>
<p>I have been told that things run smoother at Kaiser. I hope that is the case. </p>
<p>I think people do pay when they don’t have to just to end a problem. We might ourselves at times.</p>
<p>“I think people do pay when they don’t have to just to end a problem. We might ourselves at times.”</p>
<p>Agree people do. Not me, though. I am like a bull dog. It helps that I don’t work and can spend hours on the phone on hold. I’ve even told some cust. service reps I will hold all day when I have asked to speak with their supervisors and they give me the bull that the supervisor isn’t there. </p>
<p>:)</p>
<p>If you ever want to work, you should start a business and offer your services. “I will fight for you!”</p>
<p>^ I have seriously thought about it. </p>
<p>I had my out of warranty 42" Samsung Plasma TV completely rebuilt (every major part was replaced.) I didn’t really have a leg to stand on with that one but I still didn’t let that stop me. </p>
<p>People hate arguing this stuff which gives you an opportunity.</p>
<p>@DStark
Because you only hear complaints. No one remarks when things are going as expected. They look up the name of a doctor on the plan, call up the doctor, make an appointment, see the doctor, get the expected examination and treatment or prescription, pay their copay at the time of the visit… and never deal with it again. They do not go posting on the internet or griping to their friends. It’s not noteworthy or newsworthy. </p>
<p>Anthem has some very dissatisfied customers and some extremely happy customers, and then all of the people in-between who are just not experiencing anything worth talking about, one way or the other. If 90% of their clientele falls in that middle category, then they’ve got nothing to worry about. </p>
<p>Samsung was really tough though. It took several days just to get them to agree to send service person to come out. I had researched before I called them and saw they had a similar problem with their LCD TV’s (turning off by itself and then not being able to turning back on for hours.) They were repairing those even if they were out of warranty because of a defective part. Of course they told me plasma’s weren’t effected, but I told them it was only because they probably didn’t want to admit that yet. So, they sent a guy and he checked everything, but of course, it was working at the time. He got it back on the wall and turned it on but as he was packing up his stuff (he came with something similar to a massage table to put the TV on) it turned off by itself. He was gobsmacked. So more checking but he still couldn’t find the problem, so ordered every part and came back and replaced them all. This was 4 or so years ago and TV has been fine ever since. I wasn’t charged for a thing. </p>
<p>Emilybee, :). </p>
<p>Calmom, nah. </p>
<p>There are problems. </p>
<p>Just one example…</p>
<p>Anthem has zero people in their network who do breast exams in Marin County.</p>
<p>I am talking about the covered california plans.</p>
<p>dstark, have you ever contacted Dave Jones’ office? Zero people in an entire county for such a basic exam seems like a violation of the adequate-network rule.</p>
<p>My D had a problem with her new insurance in Washington. She chose a large, well-known, well-regarded medical group in the Seattle area. She called the provider who assured her that they take all exchange plans. She called the insurance company who assured her that all providers in that medical group are covered. I went into helicopter-mom mode, and spoke with the head of billing at the doctor’s office and got the same assurances. So she went to the doctor. </p>
<p>This week, 3 months later, she got the EOB – entire claim denied, provider out of network. So she first looked up the provider on the insurer’s website – and found her there, just as she had back in July when she made the appointment. She then called the insurer and pointed that out. She explained that although she hadn’t had her card in hand at the time of service (because of inexplicable problems with the insurer at the time of enrollment), she had documentation that she had in fact been covered, and had receipts for all payments. She also pointed out that she had done everything she possibly could have done to make sure the visit would be covered, and had gone to the doctor with the reasonable and good faith belief that she was covered. They agreed to file an appeal for her.</p>
<p>Meantime, I again called the head of billing at the doctor’s office (who remembered me from the previous call, because I was so nervous about precisely this kind of problem). She told me that the specific doctor was definitely in network, but had joined the group in April, so hadn’t been on the original list provided to the insurer last year. She said there had been a lot of problems with trying to get the insurer to add new providers since January 1. She said she’d watch for the denial, and they would refile the claim, with documentation that the provider is in fact in-network. She said she fully expects this to be resolved, though it may take 60-90 days.</p>
<p>And I know it will be resolved. But come on! How hard is it to input a new provider into an existing list?? Arghhhhh, I HATE insurance companies.</p>
<p>I actually sent Dave Jones an email today about something else. </p>
<p>I am going to think about sending him another email. </p>
<p>I should send the class action lawyers who are suing Anthem an email. </p>
<p>I don’t know if I am going to bother. I am so tired of this crap and this is our last year with Anthem.
I know emilybee would take care of this. :)</p>
<p>Sorry about your daughter’s problem. </p>