Anthem Blue Cross is Kind of Unethical

A bit of background. My very cute but occasional costly roommate slipped on a piece of paper in daughter Erins room back in December, slid a bit, and was left with some pain in her foot. She let it go for a while thinking she had pulled something. It continued hurting, so back in January she decided that a professional should look at it, and so we went through the Medical-Insurance Complex process of her primary care doc, then an bone specialist. A series of looks via two sets of eyeballs, a couple x-rays, and finally an MRI ended up with the diagnosis of a cracked bone in the arch of her foot, and a recommendation to stay off it. Big help, that.

So recently we get a letter, all official-looking, from an outfit calling itself Meridian Resource Company. MRC says that it is an “independent national subrogation recovery vendor” hired by Anthem Blue Cross. They sent us a questionnaire asking about the circumstances of the claim. WTH, wondered I. I had no idea what subrogation was, to start with, and the letter and questionnaire offered no definition.

From Wikipedia:

Subrogation in its most common usage is when an insurance company tries to recoup expenses for a claim it paid out when another party should have been responsible for paying at least a portion of that claim.

So what has happened here is that Anthem Blue Cross, doubtless looking to prop up its profits by trying to soak someone else, and without our authorization in the slightest, saw the diagnosis, and decided to try some shooting in the dark to try and find out if someone is responsible for Raegan getting her foot hurt.

This is, without a doubt, unethical. Anthem Blue Cross expended funds beyond any insurance payments to look at this, and has hired the MRC people to try and snake out info from us. This is a perfect example of why health insurance being run by for-profit companies is just not set up right. If Raegan was caused injury, and if that injury caused us to have to have an uninsured loss, then it is our right to seek reparations through the courts. It should be our choice, not the insurance company. MRC is just the bottom-feeding organism that does the dirty work.

To make this even odder, my health insurance is actually provided by my employer, and it is my understanding that my employer is self-insured and uses Anthem Blue Cross as a funds disburser. So I am not even sure that Anthem Blue Cross is even authorized to make such investigations. I am going to run this letter I received up through the company benefits people. And I am sure as heck not going to return it to this MRC outfit.


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69 Responses to “Anthem Blue Cross is Kind of Unethical”

  1. 13 Says:

    I’m in the exact situation as you and am wondering what the resolution was for this. Do I really need to complete the question that Meridian Resource sent me?

    • Bill Hensley Says:

      Well, I wouldn’t. I do not know of any reason I am obligated to provide any more information than we already provided to our doctors. Also, this Meridian outfit, I have no idea if they really are who they say they are, so there is no way I would provide them anything.

  2. Dennis Says:

    Any update? I just got one of these, too. Sounds fishy. Thanks!

    • Bill Hensley Says:

      Dennis, I never sent anything back to them, and never heard from them again. I did upchannel a complaint about this via my company; HR and Benefits acted surprised that Anthem was doing that, but there was never any feedback otherwise.


  3. Maria Says:

    I got one too. It really sounds fishy. It even mentioned I have an obligation to cooperate. The thing is who gave them the information? The hospital where I was admitted was in the paper. Talk about HIPAA violation!

    • Bill Hensley Says:

      Maria, if there is one thing I have learned while dealing with medical stuff, there is an explicit carve-out requiring the various providers to let the insurance people look at all of our medical records. The reason is to allow the insurance people the opportunities to deny reimbursement if they think (after the fact, of course) that some course of treatment was not needed. All that being said, I don’t think anyone has an actual obligation to respond to these kinds of fishing expeditions by MRC or any other company.

  4. Robert Says:

    I got one from Meridian and when called them to validate their authenticity they asked us to call Anthem Blue Cross. I will be complaining to FTC regarding sharing my private information with a third party bottom feeder when the insurance is from my employer and Anthem does check before paying the doctors for pretty clear tasks they mention in the bills.

  5. Bill Says:

    I am on my 3rd notice (Ignored the first two) and this one is stern in bold writing “WE HAVE NOT RECEIVED A RESPONSE – FAILURE TO RESPOND CONSTITUTES A BREACH OF YOUR MEDICAL CONTACT”. Sheesh, its like a bill collector. I will go to HR also, thanks for the tip.

    • Alex Says:

      Same. Third notice with the same words on it. Not sure what they exactly mean by “BREACH OF YOUR MEDICAL CONTRACT”.

  6. Sarah Says:

    Actually, even though it stinks, this is not technically unethical because in your insurance policy language there is, almost guaranteed, a paragraph stating that if you are injured due to a third party (ie auto accident or slip&fall) and receive a settlement for those injuries, the insurance company has a right to reimbursement of the medical expenses they paid. In this case though, it does not sound like there was any settlement, or 3rd party liability, so they do not have a right to reimbursement. That’s all you need to note on the questionnaire and they’ll stop hassling you.

  7. Petra Says:

    Right, this is an understandable method of determining whether another entity is liable for your medical bills. It doesn’t impact you at all, really, except that it may well keep premiums down if BCBG does in fact recoup some or all of your medical expenses from a legally liable third party. I had to fill one out, and I actually kind of like the idea of BCBG following up to make sure it’s not missing out on a way to keep my bills down/make money for themselves.

    • Bill Hensley Says:

      Thanks for your comment, Petra. I will give it some thought.

    • Sheryl Alvernaz Says:

      I just got one of those letters myself. I tripped and fell while unloading my car. No one to blame but myself. I waited a little over a month before even going to the Dr hoping I could stretch out the problem. The X-ray (which I paid $85 as my share showed nothing, the MRI which I paid over $380 for showed minor arthritis.). So I went on to a chiropractor which I paid in full for because my deductible wasn’t met. I doubt Blue cross spent even a total of $600 out of their pocket. Now I receive a questionnaire from a company I don’t even know who has been provided my medical information by Blue Cross Anthem.

      First, I resent the fact that Blue Cross has provided my information to anyone and under HIPAA laws, I’m not sure it is legal for them to be doing this.

      Secondly, why is an insurance carrier paying a secondary company (who I’m now reading is their subsidiary) to send me letters?

      People wonder why insurance is so high in the US?

      The mismanagement of our insurance dollars and the fact that insurance carriers have their tentacles in every aspect of our lives is not good for Americans living hand to mouth.

      I’m trashing the letter because I am not going to provide anyone further information.

      They claim they are “protecting my health info” but they aren’t if a company is collecting info about me in a database that is not my physician.

      It reminds me of the old collection laws that companies couldn’t talk to each other about the credit of another business ie info share and how it was illegal to do that.

      People wonder why insurance carriers know everything about you, your vehicle your health BEFORE insuring you?

      This is the reason! I’m trashing mine.

  8. Sarah Says:

    I just received the same letter…the only difference from what I’m reading you all have experienced, is that the letter references a wellness visit appointment date for my 4 months old son…did our pediatrician mis-code the visit or was this a mass produced letter and was sent out to everyone regardless if there was an accident or harm done. It specifically mentioned that ” the above medical diagnosis sounds like a result of an accident or trauma”. So weird it was a regular wellness visit, he was weighed, measured, and given some shots.

    • Sheryl Alvernaz Says:

      Yes, they collect a medical history on you in their databases for re-insurancing purposes and to show prior injury for pre-existing conditions.

  9. Pat Says:

    Bill Hensley, so what happened and how was this resolved??

  10. Pat Says:

    Bill thank you for reply….interesting.. I am wondering if Meridian (a subsidiary of Wellpoint) is recovering legitimate money to justify the money they are paid by BCBS Anthem etc which may be a huge amount of money based on something I read on the internet…”Meridian Resource Company, LLC was awarded the TRICARE Claims Review Services contract for TRICARE Management Activity (TMA). TMA is the Defense Department activity that administers the health care plan for 9.4 million members of the uniformed services, retirees and their families worldwide. The contract, effective October 21, 2009, is valued at $35.5 million for a 10 month transition phase in period and five one-year option periods. “.. It appears that Meridian has ~100-200 employees. The Anthem BCBS contract with Meridian is probably much more money than the Tricare..This company must be hauling in a lot of money which BCBS Anthem customers are paying for with higher premiums…I wonder if they are saving customers money by finding and preventing fraud to justify all that money of if they are just sending out letters to BCBS Anthem claimants to attempt to avoid paying legitimate claims or??…just some of my thoughts..

  11. Tony Simek (@TSimek) Says:

    I have gotten these from Anthem also. Although I cannot claim to have read my entire insurance policy (obviously) I really do not care. If MRC or Anthem thinks that I am obligated to assist with their data collection, they are sadly mistaken about who works for who. I am not going to help them. I return their questionairres unanswered in their own postage paid envelopes. : )

  12. wayninja Says:

    I’ve been getting hounded for months now. Their letters have increased in both tenor and intensity. “MERIDIAN has sent you SEVERAL inquiry questionnaires to determine if you have incurred injuries caused by another party…OUR RECORDS INDICATED THAT WE HAVE NOT RECEIVED A RESPONSE”

    Yeah. Some folks would take that as a hint to piss off. I guess I’m going to have to call them to let them know that their strongly worded letters have been received and that I’m not ignoring them on accident.

  13. Bill Krumbein Says:

    Bill and others: thanks for all your comments. I recently received this letter and it just looked strange to me. It read “On behalf of :BC Life & Health Insurance Company.” Nowhere does it say Anthem Blue Cross. The provider mentioned is not my usual doctor (the person I would visit first in case of an accident). It’s as if they are searching for some other party to pay even though I am allowed twenty visits with this other person. Not sure what I’ll do next…maybe just wait for the third bold print letter.

  14. Jenny Price Says:

    I got one for my mother in law for her stay in rehab after a stroke … hummm, I wonder who they want to hold responsible for that? She has Medicare and Anthem is her secondary … I think I’ll call Anthem and ask them what happened to her privacy.

  15. mc Says:

    As if it didn’t seem fishy (phisy?) enough, the language in my letter:

    “Meridian, Resource Comoany LLC (“Meridian”) is an independent national subrogation recovery vendor that has been retained to review medical claims on behalf of Meridian Resource Company.”

    So, a company that is been retained by itself to collect money? 🙂

    Doesn’t even list the plan we are under. Best case, this is a poorly communicated statement. Worst case, reads like a phising scam.

  16. MP Says:

    I received the (first) letter and am doing some research. It may be worth it to take a look at this court case: Ultimately, the court decided not to rule on the case, but the insurer is definitely trying to find a third party to go after for any medical bills they paid on your behalf. One thing is clear: If you separately received compensation in any way for the injury (for example, if you sued and received an award), the insurer that paid your medical bill will try to get some of that from you. Ideally, you wouldn’t have to respond to their letters, but I’m not sure that is really an option…

  17. May Says:

    I just called Meridian about a notice we just recieved. It had a date on it but no other information, besides my son’s name. The date reflected his 2 year check up. The question I was asked was ‘whether that visit was due to an injury’ and I said ‘no’. He did not ask any other questions.The rep said thank you and said he closed the file. He said I did not need to mail the questionnaire back.

  18. M. Davis Says:

    OK, I got the same notice/letter BUT I did not have an accident, etc. WHY would they seek other compensation when it is clearly a disease (not injury) I was diagnosed with?

  19. Kenneth C Says:

    Anthem (formerly Wellpoint) is an umbrella and includes your BC/BS and Meridian.

  20. Della Says:

    I just received the same letter as many of you. It stated a doctor I went to see on a specific date who is under investigation. I never saw this doctor nor ever heard of him; however, I did go get a Urogram done on the date with a radiology group (that has no doctor by the name mentioned in the notice) to check for kidney stones. Just something to check out which came back negative (I ended up having a UTI)… nothing related to an accident, etc. The wording was strong in the notice as most of you read in yours, that I HAD to fill out the questionnaire and so forth. Well, red flags were jumping out all over for me on this. From the information the notice gave and my gut feeling, this company is being paid to gather information for any possible future class action suit or the like… similar to being “ambulance chasers”. I am certainly not going to give out personal information to someone/some company that I do not know, especially regarding a visit to a doctor I never saw. This notice is definitely getting ripped up and put into the trash.

    • Della Says:

      Update: Today I received a second letter, two months later. Same letter but listed a different appointment date and, instead of the doctor I actually saw that day, it listed the entire medical center. So, heads up for all of you getting these, you will most likely get more. I actually saved the first letter and will continue to keep them just in case they are needed if these folks are investigated, or a class action suit is filed. You never know…

  21. Lois Tucker Says:

    I’m glad I found your page. I got a similar letter today. Meridian sounds like the equivalent of an ambulance chaser, only for subrogation claims. They must have staff combing medical records looking for ER visits, or something.

    • pat Says:

      I wonder how much $$$$$$$ Anthem..BCBS is paying Meridan to do this…ie how much of our premium dollars is going to Meridan to chase claims that are not in any way potential subrogation claims????

  22. Says:

    I was in a car wreck and the issue is the PIP runs out and you try to settle with the auto Meridian comes in with their totals and you get nothing. Now I thought I paid a monthly to Anthem for coverage and Meridian is basically taking away any settlement for pain and suffering. I got an offer of $12 grand now for 9-12 months of pain and PT. The PIP ran out the first night in the ER. Meridian is wanting $4 grand out of the settlement then the Attorney gets his 33% so leaving me with nothing more than getting screwed.

    • Rich Says:

      So you are blaming Meridian for your attorney being an idiot? Your attorney should have known there would be potential subrogation and should have asked either for your insurance CONTRACT (which has a section on subrogation) and the claims amount paid by Anthem. Your attorney should have factored the subro into the settlement discussions to give you a more reasonable settlement.

      And for those of you to say subro is unethical, it is not any different than you asking for your neighbor to pay for your roof when his tree hits your house. It wasn’t your fault, it was his correct. So it the case of insurance, your health insurance always pays first and they sort fault out later. If the other person is at fault, then his insurance would ultimately be responsible for the accident and not your health insurance. It how insurance works and its what you agreed to by signing your health, auto, homeowners, etc. insurance.

      For those claiming your premium dollars aren’t being well spent, think of the amount of dollars that Anthem would pay in error, e.g., wasn’t really their responsibility, if they didn’t purse these accidents/incidence. By minimizing the ultimate claims paid by Anthem, that helps premium payments “lower”.

      I used to be a benefits administrator for a self-funded employer and we wanted this service because any time Anthem could get subro money reimbursed, that was money we didn’t have to pay out (or better put, we were reimbursed for money we’d already paid out to Anthem).

      I won’t claim that I would like it either if I had my settlement reduced or got one of the “fishing” letters about my doctors visit but again it is to help reduce overall claims payment to help reduce premiums and you did agree it to when you accepted the insurance in the first place.

      • Bill Hensley Says:

        Well, thanks for your perspective, Rich.

      • adjuster Says:

        I am an adjuster, if your neighbors tree falls on your house, your homeowners insurance is responsible for repairs. If you have no homeowners insurance you are responsible for repairs. You can of course sue him for damages. THE ONE EXCEPTION is in the situation where your neighbor was officially made aware of the hazard and did nothing to remedy the hazard. I have handled at least 200 claims dealing with this exact situation.

  23. LS Says:

    Thank you for the warning, MaryXAlexander.

  24. Neeraja Says:

    Ok I just called the phone number on Meridans letter they sent me, first it prompts me to take a survey to receive a card, when I bypass that they try to sell me a team mobile phone, when I bypass that it tries to sell me ADT alarm systems. Is this company legit?? I can’t get thru to a human!!! Has anyone else called them and gotten thru??

    • Macho Says:

      You very likely misdialed the telephone number.

      There are a lot of shady consumer survey and contest-promoting companies out there who register telephone numbers that are very similar to legitimate company telephone numbers, and hope that you’ll mistakenly provide them with your contact information when you call.

      For example, dialing 888 instead of 800, or reversing numbers accidentally (like 654 instead of 645).

      It’s happened to me a few times when calling other businesses, and it’s definitely confusing and misleading, but luckily it sounded fishy enough that I hung up and redialed the correct number.

  25. LJ Says:

    Rec’d letter from Meridian too. Called Anthem BC today and CS rep told me to “shred” the questionnaire I was sent if the Service provider and DOS do NOT involve any accident or other injury (think “Ker-Ching”). Will hang on to the form and wait to see how many other letters I get. Refused to provide my full DOB as well- Meridian rep immed began speaking over me which I countered right back. Finally told her I don’
    t ever provide Identifier info like that and too bad so sad. I ended the call.

    Heads up folks! Call Anthem BC to inform. If enough people call in to complain, tying up their CS phone line, then s maybe something in our lifetime will end such outrageous sniffing out of our personal info. If Meridian wants personal identifiers all it has to do is have Anthem BC provide it to them, not members stuck with Anthem BC as their health care insurer!

  26. Peggy Says:

    My letter too referenced BC Life and the provider as the health district where I had therapy. I did an online response. Will see what happens

  27. pdfender Says:

    Thank you. I thought it might be fraudulent, so I googled it and found this blog.
    In the shredder it’s going.

  28. Injured Hopes Says:

    Well, folks…. subrogation is a common practice in the insurance industry and is used to recoup the costs of claims paid out by the insurer when another party has liability. More often than not, if an auto-insurer had an insured with a policy coverage of $100k, and Anthem paid $40k out in medical, any settlement that is made could be subjected to lien/hold as Anthem has a vested interest in recouping their losses too. However, the “made whole doctrine” does have a lot to do with this. Meridian is an Anthem owned company (formerly WellPoint) and they don’t “pay Meridian to do this”, it’s what they do as part of their business. As far as filling out the form, you’re better off submitting that form to your attorney to address, failure to respond doesn’t relieve any insurer of liability to pay valid medical benefit claims, but in the event a settlement comes about, it does give them an edge to go after you.

    • RUTH RATER Says:

      When I look them up on line,it says no such website set up.
      I then tried to call them and mailbox is full and directs you to the operator but no available!

    • Sheryl Alvernaz Says:

      Actually they are documenting pre-existing conditions for future insurance eligibility don’t kid yourself.

      No insurance company pays for subrogation if the expense of a court case, attorney etc. is less costly than subrogation.

      $2500 wasn’t enough to subrogate for on a third party water claim damage.

      This is BS and it’s being done in the guise of documenting (data collection) but for for pre-existing conditions.

      Congress and the AG needs to be made aware of this practice.

      Yes, people do have a right to subrogation but sending a letter out for a well baby check sorry that’s data collection.

      Additionally there is plenty of evidence here to suggest that subrogation isn’t the only interest.

      Their letter states that the claim has already been paid?

  29. Sandra Says:

    Called them and waited 20 minutes for them to pick up. My time is valuable too! My visit was to set up a primary doctor. Normal bloodwork done. They wanted to know about accidents or injuries. I told them that it was ridiculous. None to report for the visit.

  30. Steve Says:

    They sent me the questionnaire because of a bill for heart failure treatment.

  31. Thompson Says:

    Same here, just received third request! Same threat about if I fail to respond. This type of threat crosses the line, especially seeing how no event in my life has prompted this level of intrusion. A simple cat bite! I entered into no agreement with Meridian and for them to imply that they have the power to cause a “breach of contract” between myself and Blue Cross. Well, I will call them out on that false fact and do whatever I can to bring awareness to this unprofessional organization. Here is a tip Meridian… Professionalism goes a lot further than bully tactics by non-professionals who compose these letters exactly as a scam artist would. I communicate with Blue Cross and Blue Cross ONLY! My contractual obligation is satisfied at that level. Mess with my insurance over not complying with your wish and I will see you in court.

  32. Anna Says:

    Call your insurer’s customer service rep.

    I received a “3rd” notice (never got the 1st or 2nd) about a simple medical procedure that had gone horribly wrong. Thinking these people were ambulance chasers, I called Blue Cross and spoke to a customer service rep who told me that Meridian is contracted by them and that I should complete the paperwork.

    The rep also stated that once I completed the form, I probably won’t hear anything else. But I’m not sure. If ever there was a case for malpractice, it’s my experience. I figure I’ll wait and see.

    I also made a recommendation that Meridian make it abundantly clear that they are working on behalf of Blue Cross. On the Meridian cover letter, it states: BC Life & Health Insurance Co. That could mean “British Columbia”, “Baja California” or “Betty Crocker”.

    I completed the form on-line. The paper and the on-line forms weren’t geared for medical malpractice incidents. Meridian needs to spend the money to tweak their forms.

  33. J Says:

    Well folks, perhaps you should obtain copies of your health care policy because by signing up with said company you make a legal contract to provide information for possible situations like these. Yes they can legally send you letters, no it’s not harassment, many have tried and unless Meridian is sending you several letters a week it is not harassment in a legal standpoint. Receiving up to 3 letters over several months does not constitute harassment sorry folks. Yes they can terminate your coverage and or stop paying claims submitted if you do not reply.
    Now that you are all fired up, why don’t we explore what they actually do at Meridian. Yes you get a questionnaire you can go on the internet and answer it, you can mail it back or you can call. Generally it takes a few minutes to say hey this wasn’t an accident. If you call you are required to confirm your identity by supplying 3 pieces. the reference # supplied on the letter, the date of service supplied on the letter and your date of birth. That’s all. They confirm the diagnostic code used, which due to the Federal Hippa laws is all the information they are supplied with. They are not trying to get any money from you, the claims investigated are already paid, they just want to recoop any monies paid for services that where the fault of another provider. Not another person another provider, meaning your friend who rolled their car you were in is safe. Oh by the way that money recovered helps keep premiums lower than the national average. Plus there are plenty of people who try to game the system, making a settlement with a car ins company and not paying the med bills back. Yeah it’s legally in your policy, maybe if people would educate themselves and take responsibility you wouldn’t get companies like this that send letters and all that.

    • Sheryl Alvernaz Says:

      A “well baby check” diagnosis code would not prompt a letter neither would a lot of diagnoses described here ie Kidney stones to name another, So please explain how, you arrive at your conclusion?

      I think it’s pretty safe to say this is data collection.

  34. Says:

    and on that note…

  35. Gigi Says:

    Hi Bill,

    I just received my first “final notice”. Did anything ever happen over the years? I’m going to complain to my benefits department. I go to the chiropractor for adjustments. It looked very fishy so thank you for having this blog. It’s really helped out.

  36. Teddy Says:

    Shred these. To “J” (Aug. 30, 2016) I would say — Do you troll websites to spread disinformation? (untrue information) Go pester some other group. According to the Federal Government Consumer Protection Agency; There is no disclosure of safeguard under 45 C.F.R. § 164.103 on these letters, and where a health care provider may enter into an agreement with Meridian, no signature on any policy can force you to comply with a third party such as Meridian, that is seeking personal information for their own means. Meridian is not beholden to the HIPAA Privacy Rule. They use teeny words, at the bottom of a page with your provider patched in, and it looks official but in fact the words are incongruous to one another like; . . as mandated by HIPAA. . . information is shared . . . agreement with your health care provider. If it was real, the HIPAA Privacy Act would be indicated by the section (§) that applies. Have you ever gotten a very important letter about the expiration of a warranty on a vehicle that you no longer own? A bill from Sirius Radio for service on a car they don’t list? This is the same. It is a fraud. Meridian is a third party “recovery” group, that traffics in your personal information, which they resell to research people, lawyers, bill collectors and telemarketers. I have no doubt that most insurance companies are paid to engage them. However, YOU are under no obligation to feed them any information. Shred it.

    In today’s world just because someone says it, doesn’t make it true, It just means they said it. ALWAYS call a State or Federal Consumer Protection agency, Protect your personal information, no one else will.

  37. Teddy Says:

    Bill thanks for the blog!

  38. uber Says:

    I just got a letter from them (2 of them) my insurance is Anthem. The provider was someone else: THANHAN V NGUYEN citing a family member as a patient. Weird. I don’t know what to do. Looks like a major insurance scam… I am no THANHAN V NGUYEN.

  39. Ash Says:

    First Read your policy language, once you sign up they don’t need your permission, it becomes a right they have. Yes depending on how your policy is worded they can suspend your insurance if you do not comply, Don’t just blame the big bad Insurance company many of the big companies who have Erisa plans like to try and get their money back as well. Depending on your State laws it can depend.
    Second Meridian is not contracted by Anthem, they are owned by Anthem and have been for many years.
    Third how hard is it to check a box or write no accident and send a letter back?
    Finally receiving a few of these letters does not qualify as harassment. Per a legal stance they would have to send you several letters a week for a period of months. This does not happen.
    Most anger is caused because individuals don’t take the responsibility to read policy language, letters or the thought that someone is trying to screw them. Typical American society pass the buck just like the insurance company is trying to do. Vicious mean circle we live in isn’t it.

  40. Healthcare Biller Says:

    It May be a nuisance but from a healthcare billing standpoint the claim has a diagnosis code. It is usually the diagnosis code that sends up a red flag to the insurance carrier to send the subrogation notice. The problem with not sending then questionnaire back or not calling to update the information is this (after 22 years in healthcare) in every contract I have ever seen there is a paragraph that states the insurance carrier can investigate the cause or liability of an accident. I get that it is frustrating but there are many cases where the questionnaire is not returned or the information is not given over the phone, the claim will deny for information requested from patient not returned, and the patient is responsible for the entire charged amount. If the claim has already paid and the information is not received then the insurance company or their representative can do something called a recoupment of funds paid and then you as the patient would be billed for the charged amount.

    If either of these scenarios happens then the bill would go to collections. This is a problem in itself. If answering the third party is the issue I would contact your insurance carrier and give them the information. This would solve the problem and avoid a whole lot of issue at a later date.

    • Sheryl Alvernaz Says:

      Tell us how a wellness baby check or rule out kidney stones diagnosis would fit into your explanation.

      As a long time medical business office manager and one who knows plenty about diagnosis and CPT codes used, neither of these should flag any 3rd party.

      Blue cross is transmitting data to this company on people for data collection simple.

      They distance themselves as soon as they receive a call about it and tell you you don’t have to answer.

      For every one that doesn’t call and just fills it out, they have managed to collect the data.

  41. knightEknight Says:

    Hi Bill, thank you for your blog post. It has been just over a year since your last comment. Has there been any negative impact resulting from your lack of response to Meridian? ty

  42. Humble Jane Says:

    Hi Bill, Thanks so much for your blog! I have been getting Meridian mail after a very minor auto incident in 10/16. I thought this was trash from bottom feeders who got hold of my info, and then I moved and this mail was forwarded to me. Now I have mail from MRC that says “final notice”, has my former MD info and date of appointment on it. Do I need to fill this survey out and turn it in? Is it true this sort of thing will this go to collections?

  43. Humble Jane Says:

    P.S. the language in this notice says “Final Notice” and “breach of contract” and “In accordance with HIPPA”

  44. Humble Jane Says:

    I just spoke with my former insurance company, Anthem Blue Cross. Meridian does work for them and you do need to send the survey back to avoid being sent a bill or collections….

  45. Humble Jane Says:

    Thanks so much for getting back so quickly! Hummm…. well Anthem now has a recording of my calling and inquiring so likely best to submit, since the health company recommends I do this… confusing…. to send or not to send questionnaire…

  46. Michael Says:

    Thank you for your blog. I found it most enlightening.
    I received my letter from Meridian Resource Company today. I have been the victim of insurance fraud more than a couple of times. I know what I am writing about when I write that Meridian’s letter has “scam” written all over it. Past experience has taught me that when someone, (or an organization), claims to represent an insurance company, it is most definitely a fraud. I have also been the victim of fraud committed by genuine representatives of insurance companies. I have learned that if I cooperate with these people, they twist the information I give them around and use it against me. (I always blame myself for this.) When I do not cooperate with them, they usually get tired of threatening me and drop the matter. Only on two occasions was my “refusal to cooperate” used against me. (I blame the insurance company for this.) I have read about the matter of insurance fraud extensively. Usually the fraud is committed by the insurance companies against their policy holders, not the other way around as the insurance industry would have you believe. You may have read the advice given by people who claim that it is the duty and obligation of the policy holder to cooperate with the scammers/ insurance companies. These people will tell you that you must comply with the demands made upon you. These people always turn out to be employees of an insurance company or payed representatives of the insurance industry. You need to consider the source regarding such advice.
    If you are a resident of the State of California, do not expect to receive assistance from the Insurance Commissioner’s Office. Former Governor Gray Davis sold the California residents out to the insurance industry decades ago. He did this shortly before being kicked out of office for making secret, illegal deals with Enron and Pacific Gas and Electric. Currently, the Insurance Commissioner’s Office is still bought, payed for and owned by the insurance companies. California residents also can not expect assistance form the Department of Consumer Affairs. This agency was defunded by former Governor Arnold Schwarzenegger and as a result, remains dysfunctional to this day.
    The best course of action is to ignore these letters from Meridian Resource Company and stone wall their demands regardless of what medium they are received in: (by telephone, by electronic mail, by post). By taking this course of action, no matter what the result, you will not have yourself to blame. I will not respond to the letter sent me but will retain the letter for future reference, if future reference need be.

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