Shameless Corporation of the Week Award

This weeks Shameless Corporation Award is shared by Horizon Blue Cross Blue Shield of New Jersey and the company it contracts with to manage claims, Magellan Health Services. Magellan is notorious for denying benefits to the Blue Cross patients. In this case, a young woman who was a victim of date rape was unable to receive mental health benefits even though she was insured. Magellan stopped paying for her mental health visits with a psychologist for no reason. They just said "no"and appeals were met with further denial.

Lois Gorwitz is a psychologist who worked for Magellan for two years as a claims reviewer and she said the culture and pressure from supervisors was to deny claims. Gorwitz said the company denied claims because they are in the business to make money. She quit because she was uncomfortable with the pressure to deny valid claims. Magellan is expecting 2009 profits of $210 million, exceeding predictions.

Horizon Blue Cross Blue Shield is the states largest insurer and they posted $5.5 Billion in sales last year. To see more about EverythingHealth's Shameless award recipient, and the college student who was denied benefits, watch this Vid.


Kellie said…
This is disgustingly greedy and severely sad, especially when this woman who is so motivated and has has set high goals for herself and in the process of achieving so much to have a better life.

The scary thing with them denying mental health benefits in someone depressed to the point of thinking about suicide like she mentioned, or anyone in her situation who was to venerable at the time and couldn't find the strength within or any outside support needed how many people would be pushed over the line for suicide when their battle seems to tough to deal with alone?
Leslie said…
Shame, shame, shame. Glad you are shining a light on these abuses. Not that it will change anything.....
Anonymous said…
I had much the same problem with Magellan, where they denied payment for services that were pre-approved by my HMO. I finally stopped trying to deal with them, and started complaining to the HMO they had sub-contracted from. THAT solved the problem
prb said…
We are just going to Cigna from Great-West. Does anyone know if it has a good rep?
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