Medco ultimatum

[Guest guest]

Dear Sue,

I would be very suspicious of a letter like that. They could be betting

that the doctor will not answer and they will get rid of you by default.

Once when you had to be pre-approved for surgery, except for an emergency,

Jimmy had to go to the hospital for a kidney stone. The insurance company

called the doctor and he never returned their calls, so they denied our coverage

and refused to pay the hospital and paid the doctor. Now what is wrong with

this picture? I wrote and said it was not my fault if the doctor didn't return

the call, I had called his office repeatedly, but he was and still is an

arrogant SOB. They refused to pay. I sent a letter to the board and asked for

a re-hearing and they again refused. This time I had my lawyer write them a

letter and in 3 days there was a letter in my mailbox saying that they had

another meeting of the board and decided to pay. It was the carrier for the

company he worked for who had that stupid requirement. Then some bean counter

could deny the surgery.

I would send them a certified kletter, with return receipt requested and have

them sign for it and the card will be mailed to you, so you know when and who

received the letter. If it is returned to you as being refused, do not open it,

but give it to your lawyer. Some insurance companies are waiting for any excuse

to drop you, you are a liability to them because of the cost of your drugs. I

know you will act swiftly and not procrastinate. I would be furious, too.

Blessings,

Lottie