Re: How to explain to an insurance company

[Guest guest]

, to my knowledge, does not have an ICD 9 code so what you will

probably need to do is print off his work from his website. I

believe when he bills, he uses specific symptom ICD9 codes so you

really need to focus less on the term and more on the fact that

your son has an immune issue that only he is truly capable of

treating which is why you would want to have all of the papers

printed to present. Show evidence that your son fits his protocol

and show that no one else does this.

It's going to be hard to convince them that phone consults should be

covered so I hope you get more input from those that have gone

through this.

cheryl

On Apr 17, 2008, at 12:16 PM, slmk67 wrote:

> Does anyone have experience with dealing with insurers who deny

> coverage for telephone consults? I was instructed by Aetna to write a

> letter specifying what is and why I am using Dr.G. Please let me

> know what you know about this.

>

> I need some sort of verbage to describe the condition, etc.

> Thanks for any input-

>

>

>

>

[Guest guest]

thanks so much for the idea, Cheryl. I was not aware there is not

an ICD 9 code. I never looked too closely.

In reference to getting some attention to this subject, it might be

interesting to create a class action lawsuit if and when insurance

denies payment- assuming I could find an atty to take it under their

wing- and pursue media attention that way...just a thought

>

> > Does anyone have experience with dealing with insurers who deny

> > coverage for telephone consults? I was instructed by Aetna to

write a

> > letter specifying what is and why I am using Dr.G. Please

let me

> > know what you know about this.

> >

> > I need some sort of verbage to describe the condition, etc.

> > Thanks for any input-

> >

> >

> >

> >

>

>

>

>

[Guest guest]

On my son's superbills, Dr. Goldberg originally used the codes for

Immune Dysfunction (279.3) and Neuro-Cognitive Dysfunction (780.9).

That was six years ago. He now uses Allergy Syndrome (477.9) and

Viral Syndrome (079.99). I don't know why it's changed, or whether it

applies only to my son or to all his patients. As far as explaining

to an insurance company about phone consults and why you believe Dr. G

is the only doctor who can help your child, I agree with Cheryl that

you will need to provide them with the information on his website.

Donna

> >

> > > Does anyone have experience with dealing with insurers who deny

> > > coverage for telephone consults? I was instructed by Aetna to

> write a

> > > letter specifying what is and why I am using Dr.G. Please

> let me

> > > know what you know about this.

> > >

> > > I need some sort of verbage to describe the condition, etc.

> > > Thanks for any input-

> > >

> > >

> > >

> > >

> >

> >

> >

> >