seriously f insurance

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  • #93181
    iowagirl
    Member

    Finally!!!

    #93180
    marions
    Moderator

    Happy to hear it.

    Hugs
    Marion

    #93179
    deadlift
    Participant

    finally got my check.

    #93178
    deadlift
    Participant

    Allegedly they are cutting me a check last week. Mind you insurance paid them in December Literally the worst doctors office I’ve used. You can never get them on the phone and dorna week their voice mail was full.

    Thankfully since wife is on ag120 and not chemo we haven’t been there.

    I still owe them 600$

    Probably wait for that to work through collections for a year. Cause screw them.

    #93172
    deadlift
    Participant

    Called MVP last week. Yup it’s in appeals.
    Called up this week. No appeals no new no nothing. Least guy I got yesterday was hot to fight it. Thinks the doctors office are, not doing thing ethically. Fun!
    Though he is leaving MVP Friday so, we’ll see how far he gets by Thursday.

    #93177
    iowagirl
    Member

    Yup….I understand totally. My old insurance didn’t require pre-authorizations for much of anything that I remember. This new one is kind of vague which bothers me that it could get screwed up, but I’m just hoping it stays fairly simple until next April when I can switch to something more normal. Right now….I have bills from July that haven’t been paid yet because of the screwups in billing…..and now more that are screwed up. I’m going to deal with it on Monday after I make a full accounting of everything in a ledger to see just where we are with things, so when I have my chat with the provider…..I can be organized and know what I’m talking about. It’s a lot to keep up with.

    #93176
    deadlift
    Participant

    That sounds rough. I for sure am super thankful that I switched jobs and insurance right after my wife’s diagnosis and the new insurance just pays, and doesn’t require any pre-authorizations. All my issues were with the old insurance. I”m not quite ready to write off the 2k$ but it would be nice to apply that to the other outstanding bills from the old insurance.

    #93175
    iowagirl
    Member

    Jonathan, Having a similar problem with the main provider not submitting claims to the right company. I was forced onto Medicare in July (am 64, but have been on disability for two years, so had to take Medicare even though I was fine with staying with my expensive, but well-paying plan). Medicare rejects the claim because it is a Medicare Advantage plan (the only one you can get prtty much on disability) because the provider sends the claim to Medicare part A and B. I call the provider…..they see the problem….fix it and promise the rest of the claims as they appear will be sent to the right place….and…of course, they don’t, so we are going to have to go through each and every claim this way. I will have to deal with this situation until next April when I turn 65 and then at that point, I will be able to choose from any of the usual supplemental insurance plans. Sooooo, I’ m having to do the provider’s bookkeeping for them to keep things straight…..something I fortunately feel good enough to do right now, but it sure isn’t something I should HAVE to do.

    I agree….your problem with that insurance are with the provider’s office, probably not the insurance company.

    #93174
    deadlift
    Participant

    Pain sucks. Sorry to hear that.

    Yah new insurance doesn’t require pre-auth. They pay everything so far.

    I’m not even sure my old insurance was the problem, it sounds to me like the doctors office was incompetent. I was fully prepared to eat the cost, but they assured me they would appeal and get money back. They even had an approval after the fact. I hate being lied to .

    Another time they wrote a script for a cat scan for another reason, on the new insurance. I kept bugging them for the authorization. “Oh we are getting paper work, oh we are waiting on the doctor”
    Come to find out we didn’t need pre-auth. Clear case of deceit. If they called the insurance to see what they needed for pre-approval like they told me they did, then they would have known approval wasn’t needed. But even that took 2 days. least i know now.

    #93173
    lainy
    Member

    Oh, Jonathan, I so hear and understand what you are going through. Although I am lucky not to have CC I had a Colectomy 15 months ago. 2 months in to healing the pain started. I was told I may have nerve damage on the bladder from the surgery. And it would take a year to heal. Really no one’s fault but in the last year the pain has become debilitating and constant. Been to 6 different Docs and no one even has an idea what to do, like try thinking outside the box???? In the last 6 months every new Doctor I try to see either does not take my Insurance, United Health Care Medicare or they do not take the Hospital network I have and do want. I am so frustrated and my snacks consist of Hydrocodone!
    I do want to tell you that my husband who was the CC patient needed a PET and we thought his insurance would not cover it as it may have been to close to the last one. I researched and found there were some PET offices where that is all that is done and the fee was 1400.00. Still high but better than what you were charged. Fortunately we ended up not needing it. I hope you can get this settled and please let us know how it comes out.

    #12758
    deadlift
    Participant

    Up until April 22, I had MVP insurance. Rather terrible stuff. Everything required a authorization. I’ve since switched jobs and have a new insurance that is light years better. Anyways.

    That was when the wife needed a pet scan before she started chemo, according to the oncologist as he wanted a base line. OK.
    They told us they were scheduling a pet scan on Tuesday, this was on a Thursday. Great.
    Monday they call and tell us the machine is broken. OK, Scheduled us on Thursday now.
    Wednesday they call up and say the procedure was denied from the doctor. No other information, no follow up, just No pet scan.

    I told the wife to just get the scan, don’t change the appointment and we’ll deal with it. We go in on Thursday, doctor assures us the procedure is needed and he’ll talk to the insurance company and appeal it. Great, get the scan. Then the front desk hits me up for 2100$ FINE. said they would sort it out with the insurance company and get reimbursed. Super.

    Ok this was my mistake, paying the bill, and not telling them to send me the bill. Whooops. But i was worried they would get pissy later if i didn’t pay this up front. And i’m honest. FM right?

    Talk to the front desk girl that is handling this several times in the meantime. Ok finally get authorization. For the procedure. I.e.e she didn’t make an appeal just argued for an authorization to get a procedure. Mind you this took a few weeks. So they couldn’t give me a reimbursement from that as the procedure and the authorization were different dates.

    I keep calling, and she tells me they are trying to get the authorization back dated. Which doesn’t make a whole lot of sense. whatever.
    Finally i give up with her and start talking ot head of finance. She tells me they are getting more documentation from the doctor and going to actually do an appeal, super.
    I keep waiting, i try to send in my own reimbursement paper work. which comes back with wrong codes and no diagnosis etc etc. SO i ask doctors for the right paper work.

    They never send it, i go in person “oh i mailed it, did you not get it?” I pick up more paper work and send it

    Finally today I call the insurance company to see wtf is going on. They say the doctors office never sent an appeal, and my paperwork doesn’t count cause they never authorized the procedure. Lovely. I call the doctors office again, they are BAFFLED! Maybe they used the wrong fax number?

    FFS.

    I call the insurance company again and THEY call the doctors office this time. They sounded like they had no idea wtf the doctors office was doing and the doctors office was all confused.

    I suspect I won’t be getting any reimbursement, but at least the insurance company is trying now to sort this out.

    I really dislike that doctors office. My wife calls it the chemo factory. The place sometimes is so booked you can’t even sit in the waiting area. She’s had to wait 90 minutes for blood work before. It’s a really not friendly place. Not to mention you can never call them and get through. The front desk people are constantly out to lunch, and if they are they they don’t answer the phone. Iv’e literally never had them call me back.

    “Oh i got your message, for the last 3 days, i was going to call you today”

    If the wife ends up back on chemo, I’m hoping to find a different spot for her closer to home. This place was 30 minutes away, and I know there are oncologists locally. I really don’t see the point in going to this place, when all the primary stuff we are doing for her care is through sloan (90 minutes away) . Anyone can wire someone up for chemo right?

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