Author Topic: An Insurance Funny  (Read 13599 times)

Kaybo

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Re: An Insurance Funny
« Reply #15 on: October 19, 2008, 01:27:18 pm »
Jan~
I think that Soundy had to switch form Cigna to BCBS of TN...

oHIo~
That is like me getting the T3 and my eyebrows realligned b/c my face has been PARALYZED for 12 years for purely cosmetic reasons...well, I guess it did improve my looks!  LOL!!   :o

K
Translab 12/95@Houston Methodist(Baylor College of Medicine)for "HUGE" tumor-no size specified
25 yrs then-14 hour surgery-stroke
12/7 Graft 1/97
Gold Weight x 5
SSD
Facial Paralysis-R(no movement or feelings in face,mouth,eye)
T3-3/08
Great life!

leapyrtwins

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Re: An Insurance Funny
« Reply #16 on: October 19, 2008, 08:45:43 pm »
Jan~
I think that Soundy had to switch form Cigna to BCBS of TN...

K -

you are absolutely right - thanks for correcting me  :-[

I'd claim I was half asleep when I posted my response, but I noticed it was almost noon at the time, so I guess that excuse doesn't work  :P

Anyway, I should have asked Soundy if she had talked to anyone "in charge" at BCBS.  Sometimes you have to go all the way to the top to get things done.

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

Soundy

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Re: An Insurance Funny
« Reply #17 on: October 20, 2008, 06:22:09 pm »
I have talked to so many people I forget who all and what position they hold on the totem
pole... I have the woman at my husbands place of work , that is our go between with BCBS working
on it too... her husband who is on her insurance and has had by pass surgery got the same letters
of denial of coverage I got saying our conditions were pre-existing (which they are ) but we were
told it would be a seamless transition and it has been anything but seamless... with her husband in the
same boat as several of us with expensive problems (and it all comes down to money) she is keeping on it ...

Going to wait to go further til I see the new doctor and how he goes about getting BAHA paid
for... he does the surgery of the post and it was his office I got the demo unit from to test drive ...
3mm AN discovered Aug 2004
Translab July 2 ,2007
3.2cm x 2.75cm x 3.3cm @ time of surgery

lori67

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Re: An Insurance Funny
« Reply #18 on: October 20, 2008, 07:52:55 pm »
Ah, yes, the vanity of all of us... wanting to have a metal bolt placed in our skull because it is so very attractive.  What with my facial paralysis and this titatium post, I think I must be ready for the runway!    Move over, Supermodels of the world!!  The BAHA models are taking over!

How sad is it when the brain surgery was the easiest part of this whole experience?  I think I would rather have the surgery again than have to deal with my insurance company!  I finally just got my BAHA surgery - from last November - paid last week.  It was pre-approved and everything.  The surgeon got paid his portion, but the hospital did not.  I was able to finally determine that the hospital entered the wrong code - one number off. But anytime I called the billing department, they insisted that they just enter what the doctor tells them to and they don't make mistakes.  I finally got so frustrated that last month I called the hospital administrator and refused to speak to anyone else.  It was taken care of the next day - and guess what - it was just a keying error on the part of the person who entered it in the computer.  Gee, isn't that what I said last December???  Well, needless to say, I got phone calls from everyone apologizing and since I had written down names, titles, dates and times of conversations, I think a lot of people got read the riot act that day.  Moral of the story - go right to the top of the totem pole if you want anything done.

Anyway, I have heard that BC/BS does pay for BAHA's.  I remember it coming up in a conversation with my audiologist.  You need to enlist the help of your audiologist and surgeon on this one.  They know how to word things so they are covered.

Now, if you'll excuse me, I think I'll go admire the beautiful metal thing sticking out of my head.

Lori
Right 3cm AN diagnosed 1/2007.  Translab resection 2/20/07 by Dr. David Kaylie and Dr. Karl Hampf at Baptist Hospital in Nashville.  R side deafness, facial nerve paralysis.  Tarsorraphy and tear duct cauterization 5/2007.  BAHA implant 11/8/07. 7-12 nerve jump 9/26/08.

Soundy

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Re: An Insurance Funny
« Reply #19 on: October 20, 2008, 08:56:56 pm »
there are 4 different BCBS in Tennessee that I know of and that is because of the handbook
they gave us ... we are on a high deductible plan and it won't pay anything on anything at all until
we have paid out $2400 out of pocket... well shouldn't say they won't pay anything ... we do each
get physical each year at a cost of $20 and mammograms are paid in full...

We are part S ...S stands for sucky... my new favorite word when thinking about insurance ... an office
visit at my PCP is $59 -79 depending on if he does ...blood work ,urinalysis and the amount of time he
spends with you ...plus lab charges... on CIGNA we had a $20 co-pay and they got the rest including lab
costs... now we are suppose to pay it all when we go and they file it and keep up with how much we are
out... he will work with us if I went in and say had an x-ray and labs and visit ... he takes $20 at visit and
bills us the rest ...so far I have paid in full but nice to know I could still be seen if I didn't have it all

Many doctors in this area have quit taking part S patients becasue it take them so long to get paid...
3mm AN discovered Aug 2004
Translab July 2 ,2007
3.2cm x 2.75cm x 3.3cm @ time of surgery