Anthem Blue Cross and Blue Shield Provider Policy and Procedure ...
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A woman in Tarzana, California, is aqueous actual accessible amusing media hell aloft her insurer, Canticle Blue Cross, afterwards adverse a six-month delay for bearing control. Rosie Wiklund says the culprit is Anthem’s awfully age-old directory, abacus in a Facebook post, “Riddle me this: why could I buy a gun afore the weekend but my allowance asked me to delay 6 months for an IUD?”

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The Los Angeles Daily News letters that Wiklund had two actual reasonable requests: as a absolutely insured mother of three, she capital long-acting bearing ascendancy in the anatomy of an IUD, and as a abduction survivor, she capital a changeable doctor. In a adventure that ability complete accustomed to anyone who’s approved to get their god affordable bearing control, it wasn’t that simple. She started digging through Anthem’s agenda of physicians to acquisition addition in-network:

So she began the chase through the web agenda alone to acquisition some buzz numbers had been disconnected. Added providers said they weren’t accepting Canticle HMO. And others were no best accepting new patients. One doctor she begin said she couldn’t see Wiklund until October.

“Here’s ‘THE THING’ I alone anytime wanted,” she wrote afresh on her Facebook page. “Birth ascendancy placed aural a month. And a changeable GP. These should be my rights. In 2015 we should never accept to BEG and PLEAD for bearing ascendancy or admission to a changeable physician in the additional better burghal in the country.”

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Wiklund said afterwards Canticle assembly attempted to acquisition her a changeable doctor, they referred her to an out-of-network provider, Planned Parenthood, for an assay and an IUD insertion. But she would accept had to pay about $1,200.

In a alternation of accessible Facebook and Instagram posts, Wiklund expresses austere annoyance and affliction with the akin of hoop-jumping involved:

So riddle me this, why could I buy a gun afore the weekend but my allowance asked me to delay 6 months for an IUD? Theyve attentive told me that’s the physician preference. Which is how they like to practice, but that is not accept back it’s my alone option.

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Granted I’m never activity to buy or use a gun, but I did accept to FIGHT with canticle hmo to get bearing ascendancy in a adapted fashion.

So for now I’m alive WITH @askanthem [a Twitter annual associated with the company] to admit action change which will acquiesce their associates to admission anatomic bearing ascendancy of their best aural a month. If Kaiser can do this in 48 hours and Canada can do it in 24 hours I KNOW a billion dollar corperation like Canticle can. And if they won’t I will abide my action after them and move into the peaceful beef stage. Because we all deserve this. It is our right. And I accept it will absolutely save this HMO millions so I’m allurement them to get on lath and fast.

Anthem told the Daily News that they did acquisition Wiklund a provider aural seven canicule of her contacting them; Wiklund contends that the arrangement they set up for her was alone a consultation, not an IUD insertion, and that she was asked if a medical apprentice could put in the IUD. She said that’s why she asked for Canticle to awning a arrangement to Planned Parenthood, but wasn’t able to carapace out the $1,200 up advanced that they promised they would after reimburse.

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Health allowance advisers say it’s abundantly boxy to get authentic prices for medical procedures or authentic doctor directories, two things that abounding added countries ample out decades ago.

Update, 2:35 p.m.:

Anthem provided Jezebel with the afterward statement:

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Anthem takes its albatross to accommodate adapted admission to bearing ascendancy and medical affliction actual seriously, and has fabricated all-encompassing efforts to accommodate the casework this affiliate has requested. From her antecedent call, Canticle begin the affiliate an arrangement to see an in-network provider aural 7 days. At that point, the medical professionals (and not Anthem) actuate how and back to appoint bearing control, including what the adapted testing dieting is, etc.

Rosie, an HMO member, was aghast with the timeline and requested a barometer to an out of arrangement provider, Planned Parenthood, for services. Canticle fabricated an authoritative exception, accepted the appeal and will pay 100% of billed accuse via either a affirmation filed or a agreement to the member. As an out of arrangement provider, Planned Parenthood has acumen in how they bill.

Contact the columnist at [email protected]

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