01/10/2023
My name is Hallie Aldrich, LMP. This is the email I sent to my representatives, the press, and the unfortunate members.
Don’t just give up on taking insurance. Don’t just hire a lawyer to “read” the contract for you.
Fight back.
Feel free to copy and paste and send to your people, change the details, make it your own.
And if you would like to sign a petition for attention from legislators, please comment below.
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Dear people,
You are a congress person, a Premera employee or department or member, a journalist, or an insurance oversight representative. I hope one of you or more will resolve an issue that I cannot.
Premera has a problem. It asks me to provide healthcare services for its members, as performed by myself and my contracted therapists, but Premera does not pay for these services. The problem is that simple, it is fraud. Premera is performing fraudulent activity under the guise of system or policy error.
Premera owes me at least $8,914. It has so for over six months. And $2500 in late fees, and $.09 compound interest on all that is over 30 days delinquent, which is all of the dates of service for which my group practice has provided Premera members massage therapy, as covered by their policies. This amount exceeds $11,000. This amount does not include my lost income as a healthcare provider who is spending her patient billing hours on an unprecedented amount of administrating. I have attached the invoice below in the body of this email.
This financial abuse is 100% Premera’s fault. It started when I requested a fee schedule before I signed my network contract, a contract “privilege” that I have been applying for since 2014. I was finally accepted into the network last spring. I asked for a fee schedule before signing, and I was sent a fee schedule, one that was reasonable. So I started submitting bills. But I received Premera payments of a substandard amount—not the stated fee schedule of $113, but of $60 per hour (which is also Aetna and Kaiser’s antiquated rate for in network payments). It turns out that I was originally sent the wrong fee schedule and the correct one is $60/hour. But Premera will honor it... and this began a series of emails and calls (calls only after I spent weeks tracking down a direct line to a caring person) over the course of six months. This series of correspondences did not result in my being paid. Why? Not because of an error on my part. I have not been paid because PREMERA’S SYSTEM IS SO INEPT THAT NOT EVEN A PREMERA EMPLOYEE CAN NAVIGATE IT CORRECTLY. To find those at fault please climb to the top offices of the corporation. These people could easily conduct professional good will—a basic business tenet—and pull out a ledger and pay me with a drafted check, but they do not.
Premera's conduct is completely illegal. The insurance commissioner’s office has complicated reasons for why and who they can help, to whom I’ve reached out to, but from whom I have not received effective assistance. And to add insult to injury, the Premera problem is only the top of my stack. Next on my collections list is Kaiser, Aetna, and American Specialty Health for similar arbitrary, inept, or capricious reasons.
This started in June. Premera still owes all or part of my allowed fees from April 30 2022 to the present, and this is true for all but a few, literally 3, Premera patient service dates.
I have included the names and emails of all the people that I have added to this email. You are paid for your job while I am not. I am hoping that one of you finds yourself compelled by positional, political, or community duty to help Premera resolve their problem and/or by championing my story, a very specific one that reflects the choke hold an entire system of insurance networks wields over a country full of healthcare providers. It’s no wonder why insurance members cannot find a provider that is in network— the smart ones gave up!
Your action is my solution. This is now a community problem in the form of my paycheck. If you plan to help me collect $8,914 (plus) then please contact Carrie Johannesen directly and cc me, Carrie.Johannesen@premera.com. Please do not go directly through me, as I have exhausted all possible solutions. Carrie has been designated as my direct contact by someone, I'm not sure who, some supervisor whose team is allowing all of this to happen, as is approved by Premera’s policy of blatant, financially abusive, capricious, arbitrary priority of paperwork over provider. But Carrie has the answers that you need, please reach out to her directly. If you are a journalist intent on collecting information for your story, please feel free to reach out! If you are a member/patient, please reach out to Premera with your feelings on the situation, which is, aside from your deductible or copay, that zero of your bill has been paid.
I didn’t send this email sooner because I thought, to myself, no, this is almost over, this will be resolved soon, finally.
That was a month ago. After months and months of thinking the same thing.
Thank you for your time and support,
Hallie Aldrich
Movement Specialist
Pilates Master Instructor
Trager® Bodywork Practitioner
Licensed MassageTherapist
