GD MAPD Won't Turn Loose... Help....

[G.Gordon]

We picked up a new H/W couple 2/09. He came from CIP and she from Health???... I'll look tomorrow.

Bottom line, he has had no problems. She on the other hand has $68k of medical bills stacked up. Every month since taking on this lady we have been on the phone with Medicare because her providers for her cancer treatment keep getting denials from Medicare saying she has another "primary". Every... EVERY time we call they say they have it fixed.

I just got off the phone with the Coordination of Benefits office at Medicare... THE ***ING MAPD KEEPS SENDING SIGNALS TO MEDICARE THAT 'THEY' ARE PRIMARY FOR THIS BENEFICIARY... WTF??? She's had a PDP since 2/09, sent them multiple letters and phone calls to kill the relationship.

Dog damn... this is getting silly.

 

[insurance0707]

I had the same thing last year on a case. I ended up doing a 3 way call between Medicare and the PDP plan to get it straightened out. Medicare said they couldn't call the PDP plan, they don't do outbound calls and the PDP plan said they couldn't call Medicare, they don't do outbound calls. I got on the phone with Medicare, put them on hold and called the PDP plan where the 3 of us worked together to get it taken care of . You might want to give that a try