Blue Shield of California HMO: A bleeding breast is not an emergency

[w¡n9Nµ7 §£@¥€r 123]

SAN FRANCISCO (CBS 5) ― When Daly City resident Rosalinda Miran-Ramirez woke up one morning in April to find her left breast bleeding from the nipple, she panicked. The shirt she had been sleeping in was saturated with blood. So her husband took her to the emergency room at Seton Medical Center.

...

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.

Why? Documents from Blue Shield indicate the company had reviewed the case and determined Miran-Ramirez "reasonably should have known that an emergency did not exist."

"I am like how can they say that it was not an emergency? Like, my breast was bleeding! I am not a clinical person but if your breast is bleeding, for me that's an emergency," she said.

So she appealed. And she was denied again This time Blue Shield told her she hadn't been in "any acute distress."

...

After CBS 5 Investigates asked Blue Shield about Miran-Ramirez' case, the company said it was reviewing the case again and has now agreed to pay all charges for the emergency room visit.

http://cbs5.com/local/insurance.claim.denied.2.1207332.html

[Joseph & Ana 0]

That settles it. We should have socialized medicine.

[Nikita2Charles 33]

That's insurance companies for yah, kinda surprising because blue cross and blue shield was considered one of the good insurance policy, it comes to show you there are no good guys, it's all about the PROFIT MARGIN.

Where are the republican swho keeep crying we need to keep the status quo??

[I AM NOT THAT GUY 5,715]

That's insurance companies for yah, kinda surprising because blue cross and blue shield was considered one of the good insurance policy, it comes to show you there are no good guys, it's all about the PROFIT MARGIN.

Where are the republican swho keeep crying we need to keep the status quo??

The status quo sucks!

[trailmix 77]

That settles it. We should have socialized medicine.

Yes you should.

[Sandrila 1]

a bleeding breast is not only an emergency..it sounds very unpleasant

[Niels Bohr 72]

The husband did clipped off the the nipples with his teeth, right?

[Joseph & Ana 0]

The husband did clipped off the the nipples with his teeth, right?

Thats messed up

[Mark&Steph 0]

I disagree. I bet it would be an emergency if it was bleeding from a knife sticking out of it.

[aidan80 9]

SAN FRANCISCO (CBS 5) ― When Daly City resident Rosalinda Miran-Ramirez woke up one morning in April to find her left breast bleeding from the nipple, she panicked. The shirt she had been sleeping in was saturated with blood. So her husband took her to the emergency room at Seton Medical Center.

...

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.

Why? Documents from Blue Shield indicate the company had reviewed the case and determined Miran-Ramirez "reasonably should have known that an emergency did not exist."

"I am like how can they say that it was not an emergency? Like, my breast was bleeding! I am not a clinical person but if your breast is bleeding, for me that's an emergency," she said.

So she appealed. And she was denied again This time Blue Shield told her she hadn't been in "any acute distress."

...

After CBS 5 Investigates asked Blue Shield about Miran-Ramirez' case, the company said it was reviewing the case again and has now agreed to pay all charges for the emergency room visit.

http://cbs5.com/local/insurance.claim.denied.2.1207332.html

Insurance companies in this country are scumbags the whole lot of them! I'd sooner wait in line knowing EVERYONE else also waits in line and pays instead of this system. It's a sick and twisted, fact is private companies are in business to make money number one rule.. everything else and everyone else comes after that.

[Ban Hammer 13,977]

That settles it. We should have socialized medicine.

there's a lot of bleeding boobs around here, that's for sure.

[Nagishkaw 510]

I wonder if they consider BUTTERMILK dripping out one's ####### an emergency?

[Ban Hammer 13,977]

I wonder if they consider BUTTERMILK dripping out one's ####### an emergency?

maybe it's not buttermilk...but nut butter

[Heracles 417]

That settles it. We should have socialized medicine.

Well I am still waiting on a legitimate reason to why it's better to allow boards and executives to decide our treatment.