A reader asks for the Gripe Line's help on the opposite of insurance fraud: insurance abuse Michael wrote in response to my post on medical ID theft and insurance fraud. “I’ve been frustrated for some time about just the opposite problem,” he says. “Insurance companies that don’t give a rat’s *ss about fraud!” “I had lung surgery in 2005,” he explains. “After a short hospital stay outside of ICU, I was discharged from the hospital in early 2006. In 2005, my insurer was United Health Care. But in 2006, I switched to Blue Cross/Blue Shield of Florida. The hospital (correctly) billed UHC for $24,000 out of a total of $29,000 (the surgery and ICU was the majority of the expenses). UHC paid. Then the hospital also billed BCBS the entire $29,000. And BCBS paid that too. So, the hospital was paid twice and I had to pay a $3,000 deductible where I was expecting to pay less than $500.” Michael argued for months with his new insurance company but was unable to get them to see their error. He wrote letters, called, even dealt with a resolution specialist who decided everything was fine. What a nightmare! So how do you get through to a company that is so good at frustrating claimants that it can’t even see when its being handed a gift of over $20,000? I decided to ask an expert. (My calls to BCBS went unanswered as well.) Joseph Campana is an expert on identity theft, privacy, and information security and the author of “Privacy MakeOver: The Essential Guide to Best Practices” (www.privacymakeover.com). “Dealing with a bureaucracy can be dreadful,” he agrees. “In retrospect, though,” he suggests, “correspondence should have been sent and copied to all three parties: hospital, UHC, and BCBS.” In fact, he suggests taking the problem to the fraud and abuse departments of each of the companies involved rather than going through the claims and billing departments. “The duplicate claim may well impact your reader’s insurance records, future premiums, etc.,” says Campana. So he recommends that Michael get a copy of his medical information bureau records (MIB, or 866-692-6901) and see if duplicate claims appear on that database. “I would also recommend sending a copy of the correspondence to the insurance commissioner in the state (or states) where this occurred,” he offers. “This is a great example,” says Campana, “where having an attorney write a letter to the hospital may have resulted in a more serious response. Most consumers don’t understand how effectively attorneys can be used and most don’t have access to affordable legal care. But if your reader has a legal plan through his or her employer, AARP, or if they self-subscribe to one like Pre-Paid Legal Services, he might try a letter from an attorney. Those get attention.” Technology Industry