Frustrated with insurance!

February 7, 2002

Hi everyone,

I am so aggravated with my insurance company right now. I just want

to go there and slap someone! We have Oxford Health Plans and I feel

like no one knows what they're doing. I will try to make this

brief. My daughter has a DOC band since 12/27/01. We went

for the initial consulation in November and Cranial Tech sent in the

claim to get everything started. We received a letter from Oxford

stating the claim was denied saying she did not have any facial

asymmetry, frontal bossing, etc. I sent in an appeal letter with

photos/measurements proving she does have these things and stated

that I went to Cranial Tech because we didn't have time to waste

waiting for their approval. Well, I received a letter at the very

beginning of the year saying the decision was reversed and they will

pay, stating if it is provided by a company we never heard of. I

called Oxford and asked who this other company was and what it

meant. The gentleman stated that they will pay but it is 'out of

network'. I was mad that I would have to pay for some of it, but it

wasn't a big deal. At our next CT visit, I found out they hadn't

received anything from Oxford yet. SO I called Oxford again and the

lady told me they were waiting for authorization, but now it was done

and the claim should be paid in 15 days. Then last week, I received

an Explanation of Benefits from Oxford saying the claim was not paid

because it was not authorized. I called Oxford again and the

gentleman told me the federal tax ID # did not match the

authorization # (for CT) and I would have to get CT to call and

straighten it out. SO I called CT and they explained they have 2

different tax ID #, etc. They were going to call and straighten it

out. I waited a few days and then called CT back to find out what

happens. Turns out they couldn't fix it until I get Oxford to change

the approval for CT, not this other company. (And CT never bothered

to call me back and tell me this...whole other story!) SO I called

Oxford yet again and the gentlemen I spoke with is suppoed to call

everyone that was involved with this and try to figure it out. I am

so frustrated! SO I don't know where I stand with the insurance. I

am going to call them back today, I can't wait any longer.

Sorry for the long post, just needed to vent. Anyone who had the

patience to read this have any suggestions?

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