Insurance co. forced to be a good puppy by big, bad university

I post far too much about insurance companies sucking (in case you haven't noticed, it's my Carthusian). So I've decided to celebrate something my lovely insurance company did unprompted. See, I got married in June, changed my last name, and took a permanent position in late August at the university and went from my partner's plan to my own.

So, I went in for something on Sept. 16, two weeks after switching to my own plan. The provider (U-M health system) billed my old plan. I got an explanation of benefits that showed that I was responsible for the full amount because the claim was denied (duh, because my husband dropped me when I got my own plan).

S#*! Now I have another big medical bill--$1640 this time. I called in to the provider to explain the situation and to ask them to resubmit the claim under my new member number.

"It's already been taken care of," she told me. "We figured it out when the claim came back unpaid. You're all set."

Wow. Impressive. If only Edgepark Medical (grrrrrrrrr!!!) could learn a lesson from this.

Now, here's what's really going on and why it works: the University employs a large number of people (plus they cover grad students). They therefore have a lot of bargaining power and they have really good intentions -- to both reduce costs as much as is reasonable and to provide a high level of healthcare for its faculty and staff. Additionally, they run the best hospital (and 2nd biggest) in the state. Furreal. There have actually been a number of impressive benefits offerings out of the U: they have bargained a grace period for medical flexible spending, they are starting to offer all employees a base level disability insurance at no cost. The dental offerings aren't too shabby.

Here's an idea: if you have a large pool of people, and a well intentioned organization going to bat for them against the money-grubbing insurance companies, then, well, you might actually have a shot at getting good care for a reasonable price wheee the insurance company doesn't try to weasel it's way out of paying every little claim.

I'll add that Blue Cross in Michigan is a not-for-profit organization.

Large pool of folks + single payer system where the payer actually wants a healthy (read: productive) population + non-profit insurance company (incidentally, they only use 9% of premiums to cover overhead) = really happy Laura