Technology, Meds and Insurance...big brother watching?

I have had to go on Medicaid for awhile, due to cancer treatment expenses my husband was dealing with. Since that time I have been called and asked exactly what day and time and where my next diabetes visit would be. And, the pharmacy called me at home and approached me in the store about taking a statin. The HMO wont pay for a Dex at all, so I feel like throwing that in their face. The rest of this is just really strange and not what I want to be dealing with. Today they called again, to make sure I kept my last diabetes appointment. Please no politics, but is this going on everywhere?

I would hate that!

I know with Blue Shield or it was Blue Cross, I signed up for their diabetes program and I would get things in the mail, you need to be taking this and ask your doctor to prescribe it. (statins and BP meds, which I didn’t have) You need this test etc…I would get calls too. I opted out after a couple of months.

So maybe you can opt out?

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Maybe, but I never opted in when they asked if I wanted to!?!

Laura_S, I agree with Marie20, I had the same problem with Blue Cross and Blue Shield as well as UnitedHealthCare. Many years ago, you had to opt-in for these programs, but now you have to Opt-OUT to not be harassed. I know it is strange but that is the case for health programs, credit cards, and all types of services.

The last straw for me was tobacco cessation material and I have never smoked. My employer had us completing this information yearly (and still do), and then the insurance company would send us information for like 3-4 months. I think finally an employee threatened to sue for harassment of non-smokers. It was stupid.

Big brother is definitely watching…

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Yup. It’s creepy. They call them Disease Management Programs or something. I was able to google my health plan name and some search terms like that to figure out what they were trying to do. I also downloaded a detailed manual online and learned I have the right to opt out here. Hopefully you do as well. The pressure and stress makes it worse.

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Big brother watching is misleading. These miscreants that you’re referring to are buying your information from Medicaid to generate income for their “services”. It just goes to show how much money there is to be made in health care.

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It did say Blue Cross when I called the number. But while I was looking around on my profile dashboard, I did find a rather worthless discount program that they wanted us to sign up for. They have a rewards program and I got some art supplies out of it, but this other things is yet a different discount deal where they are offering nutrition products etc. But no, this call was from blue Cross today…

I found some unknown doctor’s name on my account when I clicked on disease management. I told this person, whoever it is, that I want to opt out unless they want to discuss Dex CGM…:slight_smile:

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That would have really made me upset!

Good plan. Sorry they’re doing this. I hate it, too.

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This is super common now. You have been flagged in their computer system as someone who might potentially become expensive. I have been flagged, too. I thought, for sure, it was some kinda scam phone call. But, I called my insurer and sure enough, it was them all along.

You may have been flagged by the insurer or the re-insurer. The re-insurer doesn’t really care about any particular person until they predict a potential payout of around $500,000, so its probably the insurer. If you tell them that you want to opt-out, they will be fine with that. I got really mad at them on the phone because I thought that they were a phone phishing scam. They are subcontractors hired by the insurer.

Frankly, the insurance company analytics aren’t fantastic. I think a lot of their analysis is faulty. I’m totally OK with that. They need not know everything.

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I know right…super annoying.

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Oh lord I made a meter company stop calling me every month to ask how my diabetes management was going. I starting making up stories. Oh diabetes? Why I have not taken insulin in 3 years. Well what is your A1C? I am well under control, my A1C was recently 19.8. Sir that is shockingly high. Really, I take aspirin. OMG it went on and on for almost a year. My final one; Sir we are very concerned do you ever test your blood sugar? Yes of course. I test every month it says death each time, but I’m not dead. She hung up and never called back. You cannot buy fun like that.

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Thank you for making my day…I’m laughing sooo hard!!!

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I burst out laughing at the gym!!

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I have never had Medicare or Regence Blue Cross bug me. I am very careful to not sign up for any diabetes program. I did have an employee in the pharmacy dept at Rite Aid tell my husband that I should get a pneumonia vaccination. I suppose I should.

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That is so funny @Rphil2

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Bravo you!!! Lovely

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Bahaha

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This puzzles me somewhat. It is my understanding that, according to HIPAA, your PHI (either Personal Health Information, or Protected Health Information, depending on who you ask) should not be used for unnecessary business purposes.

The information shared for business purposes (or for that matter healthcare purposes) is supposed to be limited to the minimum necessary. That means that if the information given out is not needed to care for you, even a nurse in a hospital should not have access to it.

If your insurance company has shared your PHI unnecessarily for business purposes not directly connected to specific healthcare (like reimbursement, or deciding if a test or medication is “medically necessary” and should be covered), I’d like to know how that is legal under HIPAA, which is hugely powerful - you can end up with huge fines and even jail sentences.