You’re not paranoid if…

[firecat]

I got a phone call. The person asked for me by my first name. Then he said he was calling from [$MY HEALTH INSURANCE CO] and they wanted to review my medications.

I said “Why?”

He said because their records suggested [$VITAL SIGN] was [$INAPPROPRIATE RANGE] and my treatment was inadequate. He used that tone of voice that suggests I am expected to comply, if you know what I mean.

I said “I don’t want to” and there was a several second pause and I hung up.

I don’t really think it was a scam, but whatever it was, they went about it all wrong.

Opinions welcome. No advice, please.

Comments

[siderea]

Uh, I don't mean to map your redactions, but I am pretty sure I know what [$VITAL SIGN] was given what you said happened.

Right now, there's a huge push in healthcare in the US and UK and probably elsewhere to address [$VITAL SIGN], because its considered the primary indicator of [$CONDITION], and [$CONDITION] gets extremely expensive (for the insurance company) if inadequately controlled.

All sorts of horrifying insurance company shenanigans have ensued from this. Mostly, they've pressured the physicians to treat it more aggressively, under the assumption that if [$VITAL SIGN] was too high, it must be because, as the caller implied to you, the physicians were being negligent in prescribing.

That an insurance company decided to jump the rails and just contact the patient directly? I haven't heard of exactly this being done before, but it surprises me not at all.

[siderea]

P.S. more generally, there's a trend in insurance in the US to have special programs to "help" patients do things the insurance company thinks will reduce the insurance company's expenditures.

For instance, my health insurance company just last year rolled out free unlimited online dietician consults for weight loss, and beat the drum a lot for their insureds to sign up. Normally, my insurance plan would require me to get a referral from my PCP to see a dietician (or any other specialist), but not for this. No copays, no deductable, no referral needed, no questions asked.

Edit: but their pet company, under their control. No choosing a dietician for yourself, and good luck if your goal is something other than weight loss. It's just one tiny step removed from the insurance company treating the patients themselves.

Which is a thing, let us not forget: that was the original HMO model: captive pet doctors, doing only what the insurance company wants them to do.

[firecat]

I’ve been begged by insurance companies to enroll in their weight loss programs and their diabetes management programs any number of times, yeah. It always sounds to me like they’re saying “please come to this special circle of Hell we’ve prepared for you, where you will receive even more shaming for doing it wrong than you do now!”

[brooksmoses]

So, in short: A scam, the fact that the call was probably from firecat's actual insurance company notwithstanding.

[firecat]

This.

[firecat]

I’m guessing you think it was blood sugar or weight? For this particular call, It wasn’t. But yeah, they’re very pushy about those things in other ways.