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Consumer Complaints on Private Insurance Not Unusual


Tuesday, July 5, 2016   

DENVER – Some consumers are having a rough go with insurance companies in Colorado.

After Tyler Boon's employer switched health plans, he spent the better part of a week trying to find a new primary care physician for his family, including his pregnant wife.

Nearly every provider he called in Cigna Health Insurance's directory listed as accepting new patients had not actually accepted a new patient in three years.

Boon says when he told Cigna about the errors, company personnel apologized, but blamed doctors for not providing updated information.

"In an industry that's based on helping people to have the level of buck-passing and not caring that the directories were that out of date, really was shocking to me," Boon says.

Boon adds as a financial adviser working from home, he was able to take time to find a family doctor, but he doubts others have that luxury. He also took the time to file a complaint with the Colorado Division of Insurance.

The Colorado Consumer Health Initiative is studying the data compiled by the agency to identify the biggest challenges facing residents and to pressure companies to do better.

The biggest beefs registered include surprise out-of-network billing, inadequate networks and denial of claims.

Boon's experience is not unusual. A 2015 Consumer Reports National Research Center study found most people with private insurance have complaints but don't know where to register them.

Boon shares another common gripe: the lack of transparent pricing.

"There's no other industry on the planet that has that opaque of pricing,” he maintains. “In my job, I couldn't say to somebody, 'Invest your money with me and I'll bill you next year, and I won't be able to tell you how much you're going to pay until then.'

“You couldn't go buy a new car and have them send you a bill four months later."

Boon has nothing but praise for the hospital workers who helped bring his new daughter into the world three weeks ago, but adds he's still waiting to get the final bill.

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