Because truth be told it could be either. Im fighting BCBSNC for stupid reasons because they swear up and down that my back injury doesnt require fusion surgery despite 3 MDs saying otherwise and guess what so far they are getting away with it. I have to really laugh when articles like these come up. Just means somebodys pissed off they arent getting a bonus and the "overpayments" are in fact legit medical expenses that some paperpusher forgot to deny deny deny like they so love to do for legitimate medical expenses. Im disgusted by BCBSNC and quite frankly think they are corrupt to the Nth degree. All I can say is becareful what you wish for for "reform" because next thing you know they'll decide your medical procedure isnt "medically necessary" either. In the end BCBSNC doesnt care about anybody but their bottom line and if somebodys complaining about overpayments going out its obviously somebody griping about their year end bonus instead of it truly being legit about concerns of money. Its the cold hard truth if you dont believe it ASK the NC Dept of Insurance cause they'll tell ya the hard truth about the down and dirty games insurance companies will play until you get the DOI on your side (they helped me as much as they could but then turned out my policy was 'federally' regulated which is a nice way of saying Im screwed!!! The only way I can beat them if I lose my final appeal is ot file a federal ERISA lawsuit against BCBSNC which means hell will likely freeze over before I ever get my back surgery they'll probably hope Ill die before they lose the case and lawyers hate these cases because unless I can prove Bad faith the money isnt much.
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