Sorry for the depressing way to start your Friday morning, but CBS 5's Anna Werner has a pretty damn harrowing tale of an insurance company, Blue Shield of California, twice denying a claim to a patient's breast tumor. It seems Rosalinda Miran-Ramirez woke up one morning back in April to find her breast bleeding from her nipple. Rightfully concerned, she darted to the emergency room where doctors told her she had a tumor in her breast.
Doctors found a tumor and initially told her she had breast cancer. A biopsy later proved that assumption false; the tumor was benign.
But Miran-Ramirez said the real shock came when her insurance company, Blue Shield of California HMO, which had initially approved the claim for the emergency room visit, reversed course and sent her a new bill three months later requiring her to pay the total charges for that visit: $2,791.00.
But wait, it gets worse. After appealing the reversal, she was denied again by the health insurance mammoth. Blue Shield, it seems, told her she wasn't in "any acute distress" and "reasonably should have known that an emergency did not exist."
Miran-Ramirez's coverage, we should point out, came via her job with the San Francisco Department of Public Health.
Anyway, after Werner's report, Blue Shield decided to review the case and pay up. But we have to wonder how many claims like Miran-Ramirez's, the ones that aren't touched by the golden hand of the media, have been so vulgarly denied.