Anything to Avoid Paying a Claim
MERIDIAN, IDAHO -- I was required to subscribe to Ameriben's coverage by my university, despite the fact that I already had coverage from a decent company. In the last 2 years, I have visited the E. R. twice: once for a kidney stone, and once for a sprained ankle. Ameriben has so far taken every action (or, in many cases, non-action) to avoid paying any of my medical bills. This is how it goes, and this is a routine with which I have become most familiar : A couple months after my E. R. visit, I receive notification from my healthcare provider (physicians' group and/or hospital) that my secondary insurance provider has denied the claim. At about the same time, I receive an Explanation of Benefits from Ameriben that says that "Payment will be considered upon receipt of an ER Report". I notify the hospital that they have to send an ER Report. The hospital will not release the ER Report until they have received a request in writing from the insurance company. Ameriben claims to have sent such a request, and refuses to re-send the request, despite the fact that the hospital NEVER RECEIVED it to begin with. The one time that I was able to beg an Ameriben representative to fax a duplicate request, the hospital again mysteriously did not receive it. The hospital's medical records release staff has told me that this is incredibly common with insurance companies- they claim to send a request which somehow never shows up. At Ameriben, "customer service" representatives (though the title "customer service" doesn't quite seem to fit these people) are, at best, unhelpful and despondent, and at worst, rude and almost aggressively discourteous. They have, however, done a fantastic job of swindling an already not wealthy college student out of a premium and then refusing to help pay minimal costs for EMERGENCY CARE.
I am now facing more than $500 in fees (thank goodness my primary insurance was willing to cover their fair share), with no guarantee from Ameriben that they will cover any of the remaining fees, since they have managed to give me and my hospital the run-around for more than 180 days, after which they no longer hold themselves responsible for paying anything.