QUICK phone call FROM NGS

QUICK phone call FROM NGS

Jim DeWees

4/2/2013

Hello Everyone,


Wow, just minutes after this email went out public, I DID get a call from a
manager at NGS stating he was calling on behalf of the manager over Charity
Bright.

It makes we wonder WHO is getting these emails at Anthem/NGS.

This is the 3rd time that this has happened....within minutes of me posting
an email which names people working for the insurance company, the company
calls me to see how they can help with the situation.

This happened a few years back when I openly spoke out about how awful
Humana was with their so-called Dis-Advantage Plan for Medicare. I shared
with everyone what I found out dealing with OIG and reporting Humana to
them. It was right after I sent an email out, that someone called me.

This also happened last year with another Anthem issue, and someone called
me to see what my complaints were, EVEN THOUGH I had voiced concerns with
Anthem and a supervisor at their office. It seemed at that time that it was
odd
that immediately after I sent out an email, that someone called me from
Anthem.

SO, is there any way to see WHO is getting these emails, and WHY an
insurance company is able to read what we are saying? Honestly I have NO
problems with them reading my emails, because what I am saying is true!!
There is nothing for me to hide about! And I have the courage to make these
complaints and sign my name to them! I won't hide under the anonymous
name. Also, I have carefully considered what I post for legal protection
and reasons. What I post is true, and it is also my opinion or my view.

Anyway, for whatever reason, OR maybe it is just pure luck, after waiting
for almost a week to hear back from someone at NGS, I did get a call just
minutes after this email went out public.....very interesting.


Oh well, it was another fun phone conversation, with someone who basically
says he is happy that I know how to go through the system, and know my
options to appeal and keep appealing their decisions. He said that the most
important thing is that we get to the bottom of this claim and get to a
point where it will be paid. REALLY!!!!!! It is HIS company and HIS
people that have made it so it WON'T pay....but it is the most important
thing to him that we get this paid.....

Believe me, I told him that he was speaking crazy....he really wants this
paid, BUT his people won't pay it! I told him that I do NOT believe him at
all. And I did not appreciate him saying something that he is quite
responsible for the problem in the first place. We talked for about 15
minutes, and I said I had to go, because he was doing NOTHING to help this
situation, and he admitted that he was in NO position to make any difference
in the appeals or anything. He was interested though in what Charity did
that I was no happy with. He said he would handle it internally and won't
be able to discuss with me anything that is done as for corrective action
or anything. I laughed and said, that is code word for thanks for the
complaint, and I am not even listening to you. He said that he did
understand my concerns, and he will address them, but won't be able to share
with me what is done about this. I laughed and said, SURE. Anyway, it was
a wasted 15 minutes of my day, but I am sure I frustrated him. I KNOW he is
not in any position to make any difference in this claim deal, so there was
no benefit in being nice to him, AND also no harm in not being nice to him.
Speaking with him was WORTHLESS!! His name is
Mike Brower, just in case anyone else on here has the privilege of
speaking with this Provider Education Team supervisor at NGS.

Or if anyone needs a name to contact at NGS, call the switchboard, at
317-841-4400 and ask for:

Damon Blue: case manager for audits (Brenda's boss)
Brenda Cusik: just someone who can see the audits..not sure her title
Charity Bright: Education specialist

Anyway, just some hints on how to get in touch with people at NGS now.

Their switchboard is set up by Last Name only, and they are quite good about
ONLY giving their first names when you speak with them. My first experience
was with Brenda and when I called back, the operator said they can't look
up a Brenda and I need a last name. When she called back, I made sure to
get her last name.

This might help someone on here dealing with NGS. For example, WHEN I had
to fill out my first re-determination paperwork, I kept Brenda on the phone
with me for about an HOUR while I filled out the form to make SURE I did it
right. She was eager (had the DESIRE) to get off the phone with me, BUT I
kept on saying Wait a minute, I have another question, and I figure that
as long as I was filling out a paper due to THEM, I was going to tie one of
THEM up on the phone with me too, and waste THEIR time. The hour I kept her
on the phone only cost them the hour for her wages and her benefits!!! If
we ALL had one of THEM on the phone with us while we fill out THEIR forms,
that would cost them MORE money to do these audits. Think about that.

It sounds kind of odd, or petty, but it is THEIR fault that I am spending MY
time with these forms, so let's have THEM help us and spend THEIR time as
well doing this.....just my thought. After all, they say that If there is
anything I can do to help you, please let me know...I am here to help you.
Yeah, right. So I am going to take them at their word, and have them help
me whenever I can think of a reason....AND if I can get to them.



Anyway, keep their phones ringing...keep them busy spending their time
dealing with our questions and frustrations.

This might be like a fishing trip...where we can have THEM on the line, and
we can wear them out until they cave in and we can reel them in easier and
have them for dinner.


OR we might be the catch and they are going to wear us down while we fight
against the fisherman....and then they have US for dinner....

OK, have a great evening.

Jim DeWees, CP