Tell me about it! I’ve spent hours every month on the phone telling them why they should be covering claims that they have denied. This has been going on for years so when this happened & I would now have to pay “out-of-network” fees for my therapist, it was the last straw. I was going to be punished for the substandard service of this ins.co.

I wrote up a letter describing all the difficulties I’d been having w/this co. over the years (not only being denied claims that should have been covered but treated rudely on the phone when I tried to get the claims paid for that were allowed in my policy). I also had documented all my phone calls w/dates & who I had spoken to (some of these bozos were so-called “supervisors” who didn’t seem to understand the policies from their own company. I was continually having to explain my coverage to them).

I had my husband email this letter to the H.R. dept. of his company through which we get our insurance. It is a very large company & within a few hours, my husband had heard back from some bigwig apologizing & saying that he would be addressing these issues w/the ins. co.

I got a call from the ins. co. soon after & SUDDENLY I was their top priority & now have my very own personal representative w/a direct phone line to call every time I file a claim. And they are going to continue to consider my therapist “in network” so I won’t have to pay out-of-network prices. I think the ins. co. thought I would be very pleased w/this “special” treatment, but actually I still expressed that while my “situation” seemed to be resolved it was too bad that all the other employees of my husband’s company could not have the same “deal” as I did & that they had to be treated w/the scorn & rudeness that I had had to endure so long as they didn’t have their own private representative simply because they had not YET complained about the poor service & unprofessionalism of this company. (Yeah, by this time I was pretty riled up & it is hard to get my unriled!) They would be paying out-of-network prices or have to find another mental health care provider. It irks me that an ins. co. can basically dictate whether you can go to the provider who gives you the care that most fits your needs. I have no doubt there are many people from my husband’s company or family members that this will affect as this is a very large corporation w/many mental health services providing care for the very low-functioning to the rather high-functioning (which I am some days!).

By the way, I am a big fan of your Bipolar Beat/Blog & Bipolar Disorder for Dummies book & live near you in Indiana! I just realized that after reading this article.

I’m not a proponent of monopolies, but it seems like it’d be a lot easier and require less work (and the associated cost) to have everything standardized. You’d still need some sort of checks and balances to keep doctors and patients from taking undue advantage of the system, but I bet a lot of what we pay in health insurance is going toward paying for inefficiency.

In addition, I think if the system were standardized, it would take this huge hassle off the doctors’ plate, so they could focus on treating patients.

But I love your solution of a doctor run insurance company.