Takes Blue Cross WAY TOO LONG to pay claims...what can we do about it?

[TaraRMS]

I submitted massage therapy claims to Blue Cross/Medivae on at the end of January (2011!)...they're STILL working on them (apparently).  My providers refuse to bill VAC direct for this very reason.  When I call VAC for an update, I get the usual run-around and the call centre clerks say that Blue Cross is too busy, too many claims, yada yada yada.  How is this even acceptable?  I don't know about anyone else here, but I find it extremely offensive to have my treatment tied to an insurance company grid.  I served my country and I get treated like this?!  Even civilian companies wouldn't treat their insured this badly!  I completely understand the arms-length/due diligence matter however, surely there's a better way than to put people in the poorhouse whilst waiting for their reimbursement!  I have a wonderful case manager but even her hands are tied.  It seems to me that VAC has turned over our care to an insurance company who is, naturally, more concerned about the bottom line, pigeon-holing people into their grid.

I wonder if the new Minister will even care...truthfully, likely not.  He'll just be parroting the VAC party line..we're here to help you...but we're just too "busy" to really try.

I'd love to hear if others have had the same experience as I have had...  And does anyone think there something we can do about this? 

 

[Occam]

If we had a Veterans Ombudsman, that would be a good place to start.  The current one hasn't been seen or heard since he took over the job on Remembrance Day last year.

 

[Sigs Pig]

Just looking over their website http://www.ombudsman-veterans.gc.ca/home-accueil-eng.cfm

I see they have been busy compiling statistics, a graph and pie chart heaven! Masters of PowerPoint I bet!
But it does show the members #1 concern/complaint,

Health Care Benefits: the majority of the issues identified were in relation to delivery of service

They are also looking for some (one?) good people on their Advisory Committee
So it would be a good place to start... look in the contacts page for times and numbers to call.

ME

 

[MJP]

If we had a Veterans Ombudsman, that would be a good place to start.  The current one hasn't been seen or heard since he took over the job on Remembrance Day last year.

Maybe he is like his predecessor and will only show up when his appointment is up.


Tara,

I would do what the fine folks below suggested plus call  Blue Cross and don't settle for front line workers, they usually can't do jack for you.  Keep asking for managers and supervisors until you run out.  At each level ask for names and for the person to spell it out and exactly what their job is.  This can work pretty effectively but if it doesn't then using those name write a letter to the CEO and any other senior manager you can find outlining the problem and their employees inability to help you with that problem.

 

[TaraRMS]

Already done all of that--to no avail...they just keep on the party line about how busy they are and how many claims, they'll look into it and I should be patient.  It's so bad  a couple of my providers refuse to bill VAC, for this very reason!  I've had fabulous success doing the up-the-chain thing with the phone and cable companies, and with other insurance companies, however, it's been less than successful in this case.  My worry is for the very, very ill or those that just can't navigate the paperwork generated by these people.  We think that VAC should work in a similar manner to the CF/DND...and it doesn't.  I actually went through the Privacy Act and got my file.  It was an appalling mass--up to six and seven copies of THE SAME THING over and over. (and nothing minuted, or noted...just the same page--with a different page number by the Privacy office!)  No wonder VAC can't do anything since the files are kept in such bad condition! 

I found out today one of my cheque's is "in the post"...yeah, believe that when I actually see it...so that's over 17 weeks after I submitted the receipts.  And, as I mentioned, even my case worker is frustrated with the system as well.

I actually used the Ombudsman a couple of years ago and had he really helped resolve things, but now?  We've been left drifting in the breeze and the powers-that-be could give a rat's (insert colourful language here) about any of us.  And the new VAC Minister doesn't appear to have any qualifications that would make him understanding of our situations either...there's a big disconnect for me...if you haven't worn a uniform, how can you even hope to understand any of us who have???