Re: Fustrated with insurance company, where to file a complaint?

[Guest guest]

Dear ,

Here's a website to contact your state insurance commissioner. They

will take your complaints.

http://insuranceclaimsconsult.com/Ins.Commissioner.htm

Also, you can talk with ACCESS and see if there's any other social

services that might be available to your kids. Their number is

206-340-4505. They are knowledgeable about CVID and PID and keep

informed of all the possible help that's out there.

Others may know of other agencies that might could help.

Remember to calm yourself and try not to " screech " at them. No one

wants to help someone who's seething in anger. So wait until you can

somewhat calmly phrase your questions and speak with respect and

appreciation for any help that they can give. We found that sugar

coating goes a lot further in getting someone to really genuinely want

to help us. Now, I'm not above bursting out in tears -- but try to curb

the anger. Once you get angry, it's hard to think rationally and figure

out what to do next. And most of these agencies really, really want to

help you (or they wouldn't do what they do). So, remember that they are

the good guys who want to help you.

God bless you as you sort through this a try to get help for your little

ones. No, they shouldn't have an insurance company risking their health

or conflicting with the doctor's orders.

In His service,

dale

wrote:

>

>

> I am really upset with my insurance company right now. got a sinus

> infection which started dripping down into her lungs and further setting

> off

> her asthma and we know from past history it will lead to pnuemonia so the

> pedi ordered Biaxin which is our usual treatment since its the only one

> that

> seems to work (she's allergic to most other abx). Anyway the insurance

> company is really ticking me off, anytime the Dr orders something for an

> infection they want proof its not to treat the PID. She's been on the phone

> arguing with them and I guess it got pretty heated and she's thinking of

> refusing to take them anymore and make patients who want to keep her switch

> to Health Net, personally I can't stand the amout of bull our insurance

> (state funded) pulls but if she stops taking them were in trouble. Health

> Net is not contracted with the childrens hospital and will ship us down to

> UCLA. Its a great hospital yes but traffic is HELL, its a 3 hr drive there

> and 4-6 hours back since we usually get caught in rush hour traffic (rush

> hour seems to last from 3-8pm in LA) and I HATE HATE HATE going to LA. CCS

> picks up most of my 2 yr olds care and sends her to Valley Childrens and I

> set up there appts for the same day so its done in 1 trip and becasue the

> baby is getting seen I get reimbursed, if were forced to switch to UCLA

> that

> won't happen so we'd be facing more drive time, more appts and I can't

> afford the gas money period, I also hate the fact that our appts at UCLA

> seem to take an average of 7 hours with 95% of that waiting time, up at

> childrens were usually in and out within 1 hr except for pulmo which is 2-3

> hours. We also usually have a room at the Mc House at

> Childrens

> which is a 5 minute walk so were not stuck driving 6 hours round trip in a

> day. No such luck at UCLA.

>

> Anyway, insurance company took almost 3 weeks to approve the Biaxin, we

> waited a couple of days for the tar to come back and it was still pending

> and she was just getting worse. So I decided to not pay the gas bill and

> paid for 5 days worth assuming it would be back by then, it wasn't so I

> didn't pay the Electric either and got another 5 days worth. Well almost 3

> weeks later we have approval. Had we waited she would have had

> pnuemonina by

> now and STILL couldn't treat becasue we also use Biaxin for that. This is

> rediclious! To intentionally withhold critical antibotics from a PID

> patient

> becasue becasue you want PROOF its not to treat the PID? The PID CAUSED the

> sinus infection! I just want to scream, they did the same thing when we

> tried treating a fungal infection and wanted CCS deniles before they would

> even consider it and CCS takes a couple weeks to deny stuff usually. I can

> not afford to be paying for meds out of pocket period but I can't afford

> for

> my insurance to pull this garbage, is there someone I can complain to about

> it at the state level?

>

>

>

>

[Guest guest]

I would sit down and write a letter to the medical director of your insurance.

Then explain to them that you are going to send it to the insurance commissioner

as well as the State Board of Health etc. That is absurd but not surprising.!!!!

BARBIE

________________________________

From: <bluetaelon@...>

Sent: Friday, December 5, 2008 12:32:15 PM

Subject: Fustrated with insurance company, where to file a complaint?

I am really upset with my insurance company right now. got a sinus

infection which started dripping down into her lungs and further setting off

her asthma and we know from past history it will lead to pnuemonia so the

pedi ordered Biaxin which is our usual treatment since its the only one that

seems to work (she's allergic to most other abx). Anyway the insurance

company is really ticking me off, anytime the Dr orders something for an

infection they want proof its not to treat the PID. She's been on the phone

arguing with them and I guess it got pretty heated and she's thinking of

refusing to take them anymore and make patients who want to keep her switch

to Health Net, personally I can't stand the amout of bull our insurance

(state funded) pulls but if she stops taking them were in trouble. Health

Net is not contracted with the childrens hospital and will ship us down to

UCLA. Its a great hospital yes but traffic is HELL, its a 3 hr drive there

and 4-6 hours back since we usually get caught in rush hour traffic (rush

hour seems to last from 3-8pm in LA) and I HATE HATE HATE going to LA. CCS

picks up most of my 2 yr olds care and sends her to Valley Childrens and I

set up there appts for the same day so its done in 1 trip and becasue the

baby is getting seen I get reimbursed, if were forced to switch to UCLA that

won't happen so we'd be facing more drive time, more appts and I can't

afford the gas money period, I also hate the fact that our appts at UCLA

seem to take an average of 7 hours with 95% of that waiting time, up at

childrens were usually in and out within 1 hr except for pulmo which is 2-3

hours. We also usually have a room at the Mc House at Childrens

which is a 5 minute walk so were not stuck driving 6 hours round trip in a

day. No such luck at UCLA.

Anyway, insurance company took almost 3 weeks to approve the Biaxin, we

waited a couple of days for the tar to come back and it was still pending

and she was just getting worse. So I decided to not pay the gas bill and

paid for 5 days worth assuming it would be back by then, it wasn't so I

didn't pay the Electric either and got another 5 days worth. Well almost 3

weeks later we have approval. Had we waited she would have had pnuemonina by

now and STILL couldn't treat becasue we also use Biaxin for that. This is

rediclious! To intentionally withhold critical antibotics from a PID patient

becasue becasue you want PROOF its not to treat the PID? The PID CAUSED the

sinus infection! I just want to scream, they did the same thing when we

tried treating a fungal infection and wanted CCS deniles before they would

even consider it and CCS takes a couple weeks to deny stuff usually. I can

not afford to be paying for meds out of pocket period but I can't afford for

my insurance to pull this garbage, is there someone I can complain to about

it at the state level?