3OYS: Glendale man's heart skips beat over insurance battle

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by LiAna Gonzales

Video report by Gary Harper

Posted on August 12, 2014 at 10:16 PM

Updated Tuesday, Aug 12 at 10:54 PM

GLENDALE, Ariz. -- A Glendale man says he's at the end of his rope battling a medical bill that he thinks his insurance company should pay.

Tim Willhite takes his health seriously. "I go see my primary care doctor once every 3 months," he says." I get blood work done, so I'm very proactive and I try to stay healthy."

So about a year ago when Tim felt some intense chest pain, he wasted no time getting it checked out.

"I presented myself at the ER and went in there and said hey, I'm having some chest pain, a little short of breath, and I just wanted to see what was going on, make sure everything is okay," he says.

Luckily, Tim wasn't having a heart attack. But because of a strong family history of heart problems, his doctor ordered some more procedures to be done.

“Had the procedure been done, they said everything's paid for. no big deal," he says. "But then, 30 days later, I got one that says, hey, this isn't going to be covered. We think it's not medically necessary."

Tim was shocked at the response from his insurance company, Blue Cross Blue Shield. So he began to appeal the denial. And then, he got good news from Blue Cross Blue Shield,

He says the company told him: “We're going to go ahead and pay it, and there's no out of pocket for the consumer, being myself, and I thought hey, great. Sounds wonderful.”

But now, a full year later, Tom says Blue Cross Blue Shield did an about-face, and is reportedly saying that Tom is responsible for that procedure, which is about $2,000.

“All of a sudden, we get another letter that says 'Hey that was a mistake, we're going to take that money back; this procedure's not covered," he says.

And it got worse for Tim when he was then told: "Your case is over 180 days, so we're not even going to consider it for appeal."

With nowhere to turn, Tim decided to turn to 3 On Your Side. "I feel so wronged and I wanted to come to you guys for some help," he says.

We contacted Blue Cross Blue Shield, which looked into the matter right away. And in this written statement, the carrier acknowledged a processing error and claims it corrected it, stating: "...Blue Cross has reprocessed his procedure as a medically necessary component of his treatment.  We apologize to Mr. Willhite for the confusion ...."

Tim says he's relieved and grateful to have this put finally behind him.

“What’s ironic is what’s taken 14 months to get resolved, got resolved within 12 hours. Thanks very much to 3 On Your Side, and kudos to Gary Harper," he says.

 

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