I don't think so...

[cellio]

Dear $health_insurance_provider,

I am in receipt of your letter, sent on your behalf by my employer, urging me to fill out a "health risk assessment" so that you can provide me with an "action plan for [my] health". It appears that you are proposing to make recommendations for my medications, lifestyle, diet, and, for all I know, hypothetical affinity for skydiving, all on the basis of a questionnaire.

You are, of course, aware that as a condition for acquiring your insurance services, I designated a primary-care physician who is responsible for overseeing my care and who is, you know, an actual doctor. If you care to open up your file on me, you will see that I do in fact avail myself of his services on the conventional, recommended schedule. In other words, I already have a source of sound health advice, and I do not need to augment it with a source of less-sound advice offerred absent any actual examination of me. I understand that some of your customers might not be availing themselves of their doctors' services, but perhaps your effort would be better spent encouraging them to change that instead of offering medical opinions via email.

While you do, of course, influence my doctor (through your decisions about what you will and will not cover), I think my doctor is more likely than you are to prioritize my health over your costs. So if it's all the same to you, I plan to stick with my current plan for continued good health.

Comments

[goldsquare.livejournal.com]

I went through the same thing, recently.

The first thing I asked them is "if my providers say one thing, and you say another, I'm listening to them. Is that OK?"

Got some decent advice, actually.

[sethg]

It could be worse. They could have already diagnosed you with something your doctor didn't think you had, and worded the letter accordingly...

[mabfan.livejournal.com]

I was just going to refer her to that...

[ealdthryth.livejournal.com]

I received one of those type letters from BCBS a year or two ago. I considered filling it out, then thought better of it. When I received another a week or so ago, I tossed it. In some ways it sounds helpful, but I am suspicious of their motives.

[psu-jedi.livejournal.com]

I got a letter about a year ago from my insurance company that said something along the lines of "We see that you have (insert medical condition here) because you take (insert medication name here). Can you please fill out this survey and let us know if you're managing your health to the best of our requirements?" Of course I tossed it. I got it a second time, and tossed it then too.

[cellio]

One of my coworkers got a letter that amounted to "we see that you had $expensive-test-that-could-result-from-an-injury; is there anyone we can sue?".

[cellio]

Wow. How nice of them to go to the effort.

[zare-k.livejournal.com]

Uh... *blink* ... sure, I'll send a bunch of potentially sensitive medical information to a non-practitioner who is interested in keeping me healthy only inasmuch as that is compatible with their bottom line.

[cellio]

Yeah. They said they'd share the information with my doctor only if I gave permission, and my immediate thought was that they have that backwards.

[jducoeur]

Yeah, that was my reaction as well. There are far too many ways in which the insurance company might find this information useful that are *not* in my best interest...

[kmanista.livejournal.com]

It's nice that they're being so pro-active about interfering in your well-managed medical business, and are fighting us about covering a test that I need regularly to keep on top of an already diagnosed condition!! Do they want people to get preventative medical care or not?

If they complain about the hearing test I had last week, I may have a temper tantrum.

[sekhmets-song.livejournal.com]

Well, see, now, you are depriving that poor, put-upon health care provider from earning some money (and you know they have such a hard time doing that, these days) when they can sell your not-protected-by-privilege information to mailing lists that want to sell you the latest drug/cure/whack-job treatment that your insurance provider would refuse to cover, anyway.
Shame on you, picking on the poor, oppressed insurance companies.

[cellio]

I have a high degree of confidence that their recommendations for pro-active, preventative care all involve things that don't cost them money: eat these foods, do this exercise, stop this bad habit, etc. Somehow I suspect that the picture changes when it comes to actual diagnostics and screenings.

and are fighting us about covering a test that I need regularly to keep on top of an already diagnosed condition!!

Gah. And presumably this is something you've been doing since long before this particular company covered you, so it's not like you're doing something new. I guess it's only a matter of itme before they challenge my every-several-months visits to my opthamologist. (That's covered under the health, not vision, plan because the reason for the visits is glaucoma treatment and monitoring, not ordinary vision checks -- though she does that too while I'm there.)

[cellio]

Ah, how could I have been so blind -- picking on the oppressed victims like that. It brings a tear to my eye, and is almost enough to get me to write my congresscritters to get a more beneficial business climate for the poor dears.

Or something like that. :-)

[sethg]

The next step, obviously, is to eliminate the doctor entirely. But if you come down with leukemia, they'll be happy to send you a box of herb tea and a CD full of positive affirmations.

[caryabend.livejournal.com]

...is there anyone we can sue?

That's just a novel way of reclaiming their costs.

/sarcasm

[cellio]

It can't be that novel; pretty much every insurance contract I've ever seen has language along the lines of "you agree to let us sue on your behalf to recover costs". But the letter struck me as a little crass not because they seek to recover costs but because her medical records clearly show that it wasn't the result of an identifiable injury. They didn't need to hassle her; they already had the information.

[estherchaya.livejournal.com]

her medical records clearly show ... they already had the information.

Actually, I'm pretty sure that insurance companies do NOT have actual copies of your medical records. I think they only get medical records if they request it and with your consent. What they get is a claim form with the ICD-9 code.

When I fell down a flight of stairs in November 2004, I received (several months later) a request for information from the insurance company. Obviously no one could be that stupid to have such a fall on their own property. I must have been somewhere else and employed by someone when it happened. Who can they sue to recover costs? Worse, it defaulted to the assumption that there must be someone to sue. The problem with that was that I had to provide proof that it wasn't an accident for which someone else might have legal liability, or they were going to hold me accountable for all fees that resulted from the fall.