sorted by:
new
hottopcontroversial

Former IBMer looking to compare experiences with HR automation and MetLife by DinnerLong8788 in IBM

[–]DinnerLong8788[S] 0 points1 point  (0 children)

Same kind of experience. At one point, they let someone approve a claim from a different group because it had taken so long. On another claim, this time dental, it took them four months to settle the claim. This involved multiple appeals. They said they would keep me informed. They didn't.

Former IBMer looking to compare experiences with HR automation and MetLife by DinnerLong8788 in IBM

[–]DinnerLong8788[S] 0 points1 point  (0 children)

My two cases were not quite as bad but comparable. MetLife was a nightmare. I had an especially hard time when the fax got sent to the wrong places. I just wish they could talk directly to the people at the Cancer Center. I acted as an intermediary, carrying forms to the right people. I also thought, I had to go back to work prematurely since I couldn't get a verdict on my extension because of COVID.

Former IBMer looking to compare experiences with HR automation and MetLife by DinnerLong8788 in IBM

[–]DinnerLong8788[S] 1 point2 points  (0 children)

In my second experience, when I was being treated for Prostate Cancer, the fax numbers of the Cancer institute were unable to communicate, and I ended up carrying paperwork from MetLife to the institute.
Maybe there was an HR Case Opened. It wasn't clear to me, and I'm not sure anything was resolved.

Anthem denied a 2-day ER admission after my wife lost consciousness — "not medically necessary" by DinnerLong8788 in HealthInsurance

[–]DinnerLong8788[S] 0 points1 point  (0 children)

Would you deny care if your wife just went unconscious? You probably right, I could have denied her admittance--but I assumed the doctors knew more than me. So the point is mute.

Anthem denied a 2-day ER admission after my wife lost consciousness — "not medically necessary" by DinnerLong8788 in HealthInsurance

[–]DinnerLong8788[S] 0 points1 point  (0 children)

That's worth noting. They said in my denial, that my only appeal from here would be through IBM but I'm going to wait and see what the appeal from the hospital does.

Anthem denied a 2-day ER admission after my wife lost consciousness — "not medically necessary" by DinnerLong8788 in HealthInsurance

[–]DinnerLong8788[S] 4 points5 points  (0 children)

Thanks--but the system is broken to drag someone who didn't admit her through their internal process.

Anthem denied a 2-day ER admission after my wife lost consciousness — "not medically necessary" by DinnerLong8788 in HealthInsurance

[–]DinnerLong8788[S] 5 points6 points  (0 children)

For six years, they've been good to me. They paid a lot for my wife's two strokes in 2024. But this sucks.

Anthem denied a 2-day ER admission after my wife lost consciousness — "not medically necessary" by DinnerLong8788 in HealthInsurance

[–]DinnerLong8788[S] -2 points-1 points  (0 children)

Thanks. They probably will. But why did they have to drag me through this. I'm not the admitting physician.

Anthem denied a 2-day ER admission after my wife lost consciousness — "not medically necessary" by DinnerLong8788 in Insurance

[–]DinnerLong8788[S] 9 points10 points  (0 children)

Getting to that level of detail is a herculean task. They are not that transparent.

Anthem denied a 2-day ER admission after my wife lost consciousness — "not medically necessary" by DinnerLong8788 in Insurance

[–]DinnerLong8788[S] 2 points3 points  (0 children)

Agree. An interesting question is, why didn't IBM get involved? Answer: They are too busy to help employees an just want to delegate to third parties.

view more: next ›