Re: Help - Ins. Doctors don't speak English?

[Guest guest]

Barbara,

Is your insurance through your employer (or your husband's?). Is there a policy administrator in HR that can get involved and put some pressure on the ins. company? Did you get a delivery confirmation from Fed Ex? I would probably send in another copy of the appeal, get delivery confirmation, and definitely include your original confirmation and a letter stating that you KNOW they received the original package on a particular date, 30 days have past, and you expect an approval immediately.

Do you remember Trisha? She was fighting Cigna during the spring and summer and won on her "first" appeal because Cigna had screwed up so many times and she had everything documented. She sent them a letter stating everything they had done wrong, and before long they were kissing her bu## and issuing a check. Don't let them get away with this.

Gail, Sam and Sara's mom, DOC grads and insurance crusader

Help - Ins. Doctors don't speak English?

Hi,I need some advise please. Horizon BCBS of NJ received my appeals package via Federal Express. After weeks of speaking to them they have now finally acknowledged receiving it but don't know where it is. Also, the 30 days they have to respond to me are up. In speaking to one of their rep's I asked to speak to the medical advisors office to find out how they could lose my appeals package. She told me they did not take phone calls and if they did I probably would not understand them because they did not speak English. I told her I was told my appeal would be reviewed by a board of medical doctors. She responded, "they are very knowledgeable and have some type of medical degree, they just don't speak English". I asked to speak to her supervisor and I asked him that if these Doctors do not speak English how could they read my appeals that was prepared in English. He asked me who told me this, he did not deny it was true. I told him who had said this to me. I also questioned what type of medical degree these doctors have because some type of degree, as I was told, doesn't necessarily qualify them to make a decision on our daughter's condition. Who knows what degree they have.A complaint investigator from the Dept. of Managed Care has opened a case with previous complaints I had. I now have to send in another complaint to be added to my previous one stating that they lost my appeals package and that I was told their medical advisors did not speak English.BCBS wants me to send in another package (which I kept a copy of) and that they will work on it right away and get back to me ASAP. Should I send in another package? My contract says they will respond in 30 days to appeals. Since they haven't responded aren't they in violation of our contract agreement? They have been very incompetent and unprofessional in most of my dealings with them. Is there anything else I can do?Any advise please.Thank youBarbara (Sofia DOC Grad 9-17-02 & Catalina)For more plagio info

[Guest guest]

Wow....I am so sorry to hear the problems you are experiencing. What seems so wrong to me in this matter is if they can't speak English how can they read them first of all like you said, but also how can they determine it being medically necessary if they don't speak English? You would think they wouldn't have the education about it being non English speaking. Just my two cents. I believe you should do whatever is necessary to get things going and not stop bothering them until things are taken care of. That is really ridiculous that they lost it. Oops, sounds like their problem to me, not yours. I don't have much advice to offer but I am behind you 100% and say go get them!!

Taryn

's mom

From: catasofia2002

Plagiocephaly

Sent: Monday, September 23, 2002 7:34 AM

Subject: Help - Ins. Doctors don't speak English?

Hi,I need some advise please. Horizon BCBS of NJ received my appeals package via Federal Express. After weeks of speaking to them they have now finally acknowledged receiving it but don't know where it is. Also, the 30 days they have to respond to me are up. In speaking to one of their rep's I asked to speak to the medical advisors office to find out how they could lose my appeals package. She told me they did not take phone calls and if they did I probably would not understand them because they did not speak English. I told her I was told my appeal would be reviewed by a board of medical doctors. She responded, "they are very knowledgeable and have some type of medical degree, they just don't speak English". I asked to speak to her supervisor and I asked him that if these Doctors do not speak English how could they read my appeals that was prepared in English. He asked me who told me this, he did not deny it was true. I told him who had said this to me. I also questioned what type of medical degree these doctors have because some type of degree, as I was told, doesn't necessarily qualify them to make a decision on our daughter's condition. Who knows what degree they have.A complaint investigator from the Dept. of Managed Care has opened a case with previous complaints I had. I now have to send in another complaint to be added to my previous one stating that they lost my appeals package and that I was told their medical advisors did not speak English.BCBS wants me to send in another package (which I kept a copy of) and that they will work on it right away and get back to me ASAP. Should I send in another package? My contract says they will respond in 30 days to appeals. Since they haven't responded aren't they in violation of our contract agreement? They have been very incompetent and unprofessional in most of my dealings with them. Is there anything else I can do?Any advise please.Thank youBarbara (Sofia DOC Grad 9-17-02 & Catalina)For more plagio info

[Guest guest]

Barbara,

Maybe one of the mods, can get you in touch with Trisha. I think she

could be a great help to you. Hey Mods??? :-)

> Barbara,

> Is your insurance through your employer (or your husband's?). Is

there a policy administrator in HR that can get involved and put some

pressure on the ins. company? Did you get a delivery confirmation

from Fed Ex? I would probably send in another copy of the appeal,

get delivery confirmation, and definitely include your original

confirmation and a letter stating that you KNOW they received the

original package on a particular date, 30 days have past, and you

expect an approval immediately.

>

> Do you remember Trisha? She was fighting Cigna during the spring

and summer and won on her " first " appeal because Cigna had screwed up

so many times and she had everything documented. She sent them a

letter stating everything they had done wrong, and before long they

were kissing her bu## and issuing a check. Don't let them get away

with this.

>

> Gail, Sam and Sara's mom, DOC grads and insurance crusader

> Help - Ins. Doctors don't speak English?

>

>

> Hi,

>

> I need some advise please. Horizon BCBS of NJ received my

appeals

> package via Federal Express. After weeks of speaking to them

they

> have now finally acknowledged receiving it but don't know where

it

> is. Also, the 30 days they have to respond to me are up.

>

> In speaking to one of their rep's I asked to speak to the medical

> advisors office to find out how they could lose my appeals

package.

> She told me they did not take phone calls and if they did I

probably

> would not understand them because they did not speak English. I

told

> her I was told my appeal would be reviewed by a board of medical

> doctors. She responded, " they are very knowledgeable and have

some

> type of medical degree, they just don't speak English " . I asked

to

> speak to her supervisor and I asked him that if these Doctors do

not

> speak English how could they read my appeals that was prepared in

> English. He asked me who told me this, he did not deny it was

true.

> I told him who had said this to me. I also questioned what type

of

> medical degree these doctors have because some type of degree, as

I

> was told, doesn't necessarily qualify them to make a decision on

our

> daughter's condition. Who knows what degree they have.

>

> A complaint investigator from the Dept. of Managed Care has

opened a

> case with previous complaints I had. I now have to send in

another

> complaint to be added to my previous one stating that they lost

my

> appeals package and that I was told their medical advisors did

not

> speak English.

>

> BCBS wants me to send in another package (which I kept a copy of)

and

> that they will work on it right away and get back to me ASAP.

Should

> I send in another package? My contract says they will respond in

30

> days to appeals. Since they haven't responded aren't they in

> violation of our contract agreement? They have been very

incompetent

> and unprofessional in most of my dealings with them. Is there

> anything else I can do?

>

> Any advise please.

>

> Thank you

> Barbara (Sofia DOC Grad 9-17-02 & Catalina)

>

>

>

>

[Guest guest]

,

Great idea, I searched but had no luck in finding Trisha's addy- but I sent

the request to the other mods so maybe they or another member can find her

for Barbara.

' Mom