412-208-6000

asking about health insurance


info Type: Land LineProvider: MCImetro, Ats  Location: Pittsburgh, PA
  TYPE:RESIDENTIAL

These are nurses calling from different health plan that want to help you stay healthy. They are legit

I have received 4 or 5 calls over the last two weeks with no one on the other end. They are becoming annoying. I call back the number and it just rings.

This is the most annoying phone call I have EVER encountered. Okay maybe it's not related to telemarketing, but they are RELENTLESS! They call continuously and never the same person. They INSIST on helping you even if you don't want their help! I have come to the conclusion that this is their only job now and if they don't remain on the phone all day long, annoying people, they will be unemployed.

No one is on the phone if I answer.  I generally punch "Ignore"

See 443-430-7201 at:
https://800notes.com/Phone.aspx/1-443-430-7201

Comments with the > in front of it are from a posting at https://800notes.com/Phone.aspx/1-443-430-7201/3

Some genius from the company is attempting to legitimize these irritating calls!

>Most people seem to be agitated by the company's use of an autodailer
>and/or not having any previous relationship with the particular service
>company calling.  The calling company, service and substance, however,
>appear alright and polite.

What posts are you reading?  No, most people are agitated by the repeated calls and the continuous denial of being unable to be removed from the list.  (A list given to this company by a hospital or health care provider via bc/bs)

The area is a little "grayed" on the previous relationship part since healthways is masking the "relationship" the patient had (through no fault of their own other than going to the doctor for care) with bc/bs and NOT healthways.  So, no real relationship exists, but your company somehow seems to think one does.

No, the calling company, service and substance have no appearance of being "alright or polite" whatsoever.  No rapport has been established with the potential customer (mark) other than a random, unsolicited phone call which, on the surface is shady in the first place, but is even more called into suspicion when "the company" can't even identify itself as an organization which is not bc/bs.  

>I let the first call go like I do all calls the number of which I don't
>recognize. Actually received a voicemail message explaining that they
>were providing an education service for BC/BS.  So when they called
>again, I answered.

Yeah, right.  You are absolutely convincing me from this paragraph that you don't work for healthways and are just another random "client" who has no connection or vested interest in this organization. If there is even a hint of truth to this, there are plenty of Nigerian scammers who would love to find a person like you!

>Had a nice civil conversation.  The woman knew a lot about my medical
>history, i.d. info so I felt comfortable chatting.

You were not alarmed or appalled about the unauthorized sharing of your medical history with a complete third-party company?  You didn't question how she got you medical history?  You didn't ask for her credentials or qualifications? You just decided that chatting about your medical issues with a complete and utter stranger was perfectly acceptable and ok huh?

>Said she was with
>BC/BS (didn't make clear she was with a separate
>company, but, heck,
>that's o.k., she apparently is working at the >behest of BC/BS).  They
>provide education on health conditions >indicated by submissions to
>BC/BS.  Fine, I said, always interested in
>learning more.

So, first the woman lies to you and says she is with bc/bs then (somehow) you find out that she isn't but then, since she works at the "behest" of an insurance company it becomes perfectly logical to establish a personal and business relationship with her. Then, to make matters even clearer, it is ok to engage in this because she received the information via a submission which may or may not have been granted for dissemination by the patient but since its for "education" on health conditions its perfectly understandable.  Uhhh, OK, fine, lets move on.

>Gave me a BC/BS (?) number for a health risk appraisal over the phone
>(hra's are something everyone should do - didn't take BC/BS's so don't
>know if it's good - have taken another good one online)(check out
>thehealthierpeoplenetwurk  org for a link).  Was told a nurse would
>call me with more info on my condition and I would be receiving info via
>mail (at my address BC/BS has).  Fine.  Seems solid and legit service.


Wow! you are impressing with all the jargon. What happens if someone doesn't want an "hra" over the phone, or doesn't want to discuss their medical condition with some stranger representing a company who's sole purpose is to determine the patients medical liabilities to the companies bottom line and who fronts a third-party to masquerade as a patient advocate only to receive further data which could potentially raise the rate the patient is currently paying or subject him/her to outright cancellation?  What about that?

>The main gripe here seems to be with the calls being unwanted and the
>use of an unanswered autodailer.  Final note, I am cautious here because
>I don't trust BC/BS not to use any info I give over the phone as a
>reason to jack up my insurance premium.

This is basically a repeat of the drivel from your first paragraph.  It has nothing to do with an auto-dialer and everything to do with not being harassed by unwanted and unsolicited phone calls from a company with questionable motivations in the first place.

This is Healthways (a company hired by insurance companies like CIGNA)
http://www.healthways.com

The call is from a Healthways representative to substantiate your insurer denying a claim or pre-certification.  If you talk to them, you will see your claims being denied all over the place.  DON'T TALK TO THEM... and tell your reps to pass healthcare reform and put these crooks out of business!

http://www.healthways.com/iFrame.aspx?id=137&linkidentifier=id&itemid=137

Healthways => Careers => Opportunities

Job Description

Spec, Clinical Review I2 10- 1000048

Description (We are proud to be an EEO/AA employer M/F/D/V.)

Responsible for collaborating with healthcare providers and members to optimize member benefits and to promote effective use of resources

Assesses the medical necessity of inpatient admissions, outpatient services, surgical and diagnostic procedures, and out of network services

May manage appeals for services denied

May conduct pre-certification, concurrent, and retrospective reviews to ensure compliance with medical policy, member eligibility, benefits, and contracts. Investigates, researches, and resolves issues identified in correspondence

Reviews contract language and medical record documentation from contracted providers, non-contracted providers, and outside entities

Documents and summarizes to all parties involved in the case the investigation's result

Receives, documents, investigates, refers, and coordinates grievances and appeals

Initiates case files for each grievance and ensures compliance with organizational and regulatory requirements.


Qualifications

Knowledge - Developing professional expertise, applies company policies and procedures to resolve a variety of issues.

Job Complexity - Works on problems of moderate scope where analysis of situations or data requires a review of a variety of identifiable factors. Exercises judgment within defined procedures and practices to determine appropriate action.

Supervision - Normally receives general instructions on routine work, detailed instructions on new projects or assignments.

Experience/Education - Generally requires a minimum of two years of related experience. Generally requires a bachelor's degree. RN license required.


About Healthways:

For three decades, Healthways has been dedicated to improving the human condition. Each year, we learn more and do more for the millions of individuals who count on us to make a difference in their health and well-being. Healthways is a global provider of solutions that help employers, health plans and government agencies enhance business performance and reduce healthcare costs. Our mission is to create a healthier world, one person at a time.

Here at Healthways as we continue to make the world a healthier place, we have also created an environment where people choose to do their best work. Our unique culture thrives on mission-driven individuals who exude a high sense of energy and passion in everything that they do. Collaboration and teamwork are an essential part of everyday life for Colleagues who trust and depend on one another to achieve the highest degree of collective success. We are an organization that strives to recruit the best and the brightest individuals who take pride in the statement "I work for Healthways."


Job: Clinical / Nursing
Schedule: Full-time
Shift: Day Job

They kept calling me every day, when I answered and told them I didn't feel comfortable talking and wanted off of their list they said that if I didn't provide them with my birth date they would keep calling.  Now they are still calling, even on weekends.  When I answer, they hang up.  When I let it go to voice mail, they leave a robo-message about the great service they provide.  This is harassment.  And disturbing.  I called them back today to tell them again to please take me off the list. The rude lady I spoke with started by asking me which health insurance I have, which was alarming because the very first time I ever spoke to someone from this number they said that they were in fact cigna.  Then she asked for more detailed info about me, which I didn't give.  Upon explaining to her that I don't know who she or her company is and that this could be a phishing scam, she started getting more aggressive and rude.  I gave her my phone number and told her to find it in her system and remove it.  She agreed, but then hung up on me.  I now recall receiving a letter from them too.  I've never been harassed by both mail and phone by a company before for anything.  I'm plenty pissed.  I don't know what else to do, but the calls that they're now giving me amount to crank calls.  Even Bart Simpson would have gotten bored with this game by now.

I beg these people to stop calling me and they dont.  They say they are calling from Siemens.

If you have a letter GREAT!!! Contact your local attorney general's office, consumer affairs office and open a complaint. Make sure to note each time they've called you (attach or send records and the copy of the letter). You are right. This is in fact harassment and you can be compensated for it. In addition, they will be fined. All of this hinges on the company being legitimate. You can sue for each call made after your request to stop, especially in the face of receiving a letter that claims to be compliant to your request. Ask for the call center's address, customer service number, and request to be removed from their corporate call list. This should stop every single call from that organization period (if legit).