Teamcare - something to watch for on procedure claims

kingOFchester

Well-Known Member
Nothing but problems since getting into Teamcare.
  • Numerous billing issues, that took several calls to fix.
  • Large family practice that I use, had a hard time updating prescription info into their computer do to CVScaremark address is different then the one they had on file. Do to teamcare/caremark.
  • Maintenance drugs from Medco were never transferred to Caremark.(as promised). Numerous calls to get transfer.
  • Caremark website is flawed. Maintenance drug is now listed under my scripts, but unable to get it on auto mail. Required to log in, add to basket, and check out. Caremark has been working on the issues that they acknowledge is on their end for over a month now.
  • Dr. collects $10 for office visit, but yet get statements from Teamcare saying that I may owe more. Haven't had to pay more, but seems strange that they would say i may owe more when the office visit is clearly a $10 co-pay.


The days of easy billing, ease of scripts and zero confusion are over.
 

kingOFchester

Well-Known Member
I would call Teamcare and ask about the biopsy being part of the removal. That was what I did. It is a possibility that it was submitted wrong by the doctor.

My time comes at an expense. If I were able to get reimbursed at my current hourly rate for all the time I have spent dealing with Teamcare/Caremark, I could pay for a nice weekend getaway with that money.

In the prior 7 years, I probably spent less then an hour dealing with the old insurance company.
 

Ron Carey lives on

Well-Known Member
Generic prescriptions, lab work for kids, spouse's coverage have been the most complaints. I have found through personal experience, you have to be very thorough and persistent on claims. No use yelling at them on the phone. This was the zero payment program that hall promised. Take it up with him 2016, and vote those sobs out

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UpstateNYUPSer(Ret)

Well-Known Member
Regardless of insurance carrier, you should also carefully review all bills and submit unpaid items for appeal. Doctors are overwhelmed and mistakes do happen.
 

BigUnionGuy

Got the T-Shirt
Regardless of insurance carrier, you should also carefully review all bills and submit unpaid items for appeal. Doctors are overwhelmed and mistakes do happen.

Who has time for that ?


One of my awesome Facebook peeps....

Just posted a picture of a hamburger, they are getting ready to eat.


The Teamsters suck.



-Bug-
 

oldngray

nowhere special
Who has time for that ?


One of my awesome Facebook peeps....

Just posted a picture of a hamburger, they are getting ready to eat.


The Teamsters suck.



-Bug-

Did he also post a picture of himself standing in front of a urinal? Every detail of life is supposed to be posted on facebook.
 

BrownBrokeDown

Well-Known Member
Did he also post a picture of himself standing in front of a urinal? Every detail of life is supposed to be posted on facebook.
My family seems to think this. Noone can understand why I have been on Facebook a total of 1 time in my entire life for a total of about 15 minutes.
 

BrownBrokeDown

Well-Known Member
Update...

So the insurance says it was processed correctly from the way it was submitted, but it should be covered at 100% if it had been submitted correctly.

The dr's office says it was submitted correctly, but agrees it should have been payed at 100%.

Next step, the dr's office has to submit an appeal.

We'll see what happens.
 

Jhansen

Member
New Teamcare plan has cost me more out of pocket than the past insurance. I've had to my young son to the ER in the past, and never had a single bill. My wife took him last month, and we received a $76 bill. I know it's only $76, but I guess I'm just used to not having anything due. My son had $100,000 heart surgery 2 years ago and not one bill came for it.
 

UpstateNYUPSer(Ret)

Well-Known Member
New Teamcare plan has cost me more out of pocket than the past insurance. I've had to my young son to the ER in the past, and never had a single bill. My wife took him last month, and we received a $76 bill. I know it's only $76, but I guess I'm just used to not having anything due. My son had $100,000 heart surgery 2 years ago and not one bill came for it.

$76 sounds like a pretty sweet deal to me. Just sayin'.
 

Mugarolla

Light 'em up!
$76 sounds like a pretty sweet deal to me. Just sayin'.
That is $76 more than he would have paid under the old plan. Multiply that by a few times a year.

Have always agreed that Teamcare is a pretty good plan. Except when compared to what we had. UPS profits are up and we took a concession. That is what pisses us of.
 

UpstateNYUPSer(Ret)

Well-Known Member
That is $76 more than he would have paid under the old plan. Multiply that by a few times a year.

Have always agreed that Teamcare is a pretty good plan. Except when compared to what we had. UPS profits are up and we took a concession. That is what pisses us of.

You won't get a lot of sympathy from the majority of your customers.
 

Bubblehead

My Senior Picture
Update...

So the insurance says it was processed correctly from the way it was submitted, but it should be covered at 100% if it had been submitted correctly.

The dr's office says it was submitted correctly, but agrees it should have been payed at 100%.

Next step, the dr's office has to submit an appeal.

We'll see what happens.
Welcome to Teamcare, isn't that what "they" say?

This was the biggest warning (aside from the reduced level of benefits) I got from those I know who were previously in Teamcare as elected local union officials in the Central Region, when comparing it to the UPS plan they previously enjoyed.

They predicted we would lose significant portions of our lives, trying to part the endless red tape that is Teamcare.
Good luck and hopefully you won't lose your shirt, or sanity, negotiating this "new era" in Teamster controlled healthcare.
 

Bubblehead

My Senior Picture
You won't get a lot of sympathy from the majority of your customers.
We don't need their sympathy?
Don't feel guilty for working in a industry that pays you what the market bears.
It is a dangerous job negotiating the streets of this country and we mortgage our bodies in the process.
Why shouldn't we receive the best healthcare available?
 

Bagels

Family Leave Fridays!!!
That is $76 more than he would have paid under the old plan. Multiply that by a few times a year.

Have always agreed that Teamcare is a pretty good plan. Except when compared to what we had. UPS profits are up and we took a concession. That is what pisses us of.

Health care costs significantly more today than it did in 2007 and very little of the cost is passed to active Teamsters; UPS continues to cover the rest. Despite all the "The Sky Is Falling" threads related to TeamCare, the additional costs associated with the insurance are very little, and for most FTers, only a small portion of the raise they've received.

UPS drew the line on insurance -- it was no longer willing to provide no-cost insurance to IBT members. It also hinted at making changes to benefit packages, but those changes were never discussed. UPS was clearly p'd that a lot of PTers used the ER as their primary physician, since the co-pay was often waved; thus, a PTer seeking to save a $10 co-pay on a $60 doctor bill was accessing the ER that was costing UPS $600. Undoubtedly, the language would've become more punitive. Regardless, IBT was able to assemble a benefit package that was similar to what we enjoyed before with very little cost passed onto us. What could we have done, strike?

"Tonight on Local News Channel, UPS workers go on strike. Here's Bubblehead to tell us why: 'Not only does UPS want to disrespect us with a $37/hour wage, they want us to pay $5 per prescription on our free insurance. Sure I could get it free through mail order, but dang namit, UPS is making record profits!"

You think the public would be on your side???
 

UpstateNYUPSer(Ret)

Well-Known Member
We don't need their sympathy?
Don't feel guilty for working in a industry that pays you what the market bears.
It is a dangerous job negotiating the streets of this country and we mortgage our bodies in the process.
Why shouldn't we receive the best healthcare available?

Sounds like you want the best with no out of pocket.
 

Bubblehead

My Senior Picture
Health care costs significantly more today than it did in 2007 and very little of the cost is passed to active Teamsters; UPS continues to cover the rest. Despite all the "The Sky Is Falling" threads related to TeamCare, the additional costs associated with the insurance are very little, and for most FTers, only a small portion of the raise they've received.

UPS drew the line on insurance -- it was no longer willing to provide no-cost insurance to IBT members. It also hinted at making changes to benefit packages, but those changes were never discussed. UPS was clearly p'd that a lot of PTers used the ER as their primary physician, since the co-pay was often waved; thus, a PTer seeking to save a $10 co-pay on a $60 doctor bill was accessing the ER that was costing UPS $600. Undoubtedly, the language would've become more punitive. Regardless, IBT was able to assemble a benefit package that was similar to what we enjoyed before with very little cost passed onto us. What could we have done, strike?

"Tonight on Local News Channel, UPS workers go on strike. Here's Bubblehead to tell us why: 'Not only does UPS want to disrespect us with a $37/hour wage, they want us to pay $5 per prescription on our free insurance. Sure I could get it free through mail order, but dang namit, UPS is making record profits!"

You think the public would be on your side???

That's what they want you to believe.
I don't believe that is what happened at all.
It's been my contention that it was never the company who truly demanded they get out of the H.C. business, rather the union is who wanted those funds allocated to their healthcare funds instead.
With virtually every other sector of the union contracting and retiree numbers increasing, actuarial reports certainly indicated that the Central States Healthcare Fund would soon spiral downward if not infused with a new supply of members to contribute.

Had the company been the one insisting they needed this development, it would have been a significant bargaining chip in other facets of the contract.
Instead, the company "smelled" this weakness and flipped the script on Teamster negotiators.

I have also repeatedly contended that the Teamcare plan would be very comparable, on the surface, to what we had previously until 2016 and the next IBT General Election takes place.
It will be then, in 2017 and beyond, that you will see the true Teamcare plan they envision.
I qualify this statement by asking anybody to explain to me why such a healthy, vibrant and fiscally sound plan would need its members to suddenly contribute unprecedentedly in the form of an annual deductible on the last year of a contract, after its negotiators have sought reelection?
I think I know why.
Because they know the "wheels are going to come off" if they don't.
It will only be the tip of the iceberg, as we will never "unstrike that match" or "put that toothpaste back in the tube" if you will.

Look, I understand that it is counter-intuitive to think that we were duped and lied to.
I too want to believe everything will be fine, but there are too many clues to the contrary and too many holes in the story.
Believe me, I hope I am wrong.
 
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