Re: Spect Scan / Blue Shield

[Guest guest]

I would not recommend Santa Imaging. Does BS give you any other

facilities that can do the Spect? I saw Dr. Amen from the Amen Clinic give a

lecture, and if my son has another spect scan, I will try to have it done

there. Maybe you can get recommendations from other families?

BS did cover part of my son's spect scan. What SMI failed to mention to me

when I set everything up was that the anesthesiologist is a freelancer (did

not find this out until AFTERWARDS) and he wanted $800 cash at the end of

the procedure. Very, very weird.

SMI did not provide any kind of interpretive report, and if I wanted copies

of the images, they were another $45 each.

Kristy

From: [mailto: ] On Behalf Of Cheryl

Lowrance

Sent: Tuesday, June 03, 2008 1:24 PM

Subject: Spect Scan / Blue Shield

We'll probably be going in for a Spect Scan in a few months so right

now, and I are trying to figure out how to make this as

easy as possible as far as finances go. I've contacted my insurance

co Motion Pic/BS and they've told me that as long as it's ordered by

an MD and is medically necessary, it will be covered. The problem

I'm running into is if Santa Imaging is a BS provider. My

insurance company is saying they are out of network. Dr. Uszler will

be covered, but SMITA will not and they will only cover 70% of the

" allowed " amount. Basically, she told me it's going to cost me a

lot. I can't afford it if it does. Does anyone know if SMITA is or

isn't a BS provider? Anyone with BS been through it already? With a

BS provider she said it would be covered 100%. Of course, Dr. G

won't let us go anywhere else. If we can't afford it, we simply

can't get it done.

Cheryl

[Guest guest]

It's very interesting that you should post this question now. Dr. Uszler is

indeed a preferred provider for Blue Cross/Blue Shield (we have the federal

program). Here's what happened to us . . .

This insurance was new for us; we'd always had an HMO, but switched to this

insurance because of Dr. G. Dr. Uszler informed us that we'd have to pay the

$1,875 (+$750 for sedation because Noah can't stay still) up front and then get

reimbursed for the procedure. Dr. Uszler used an out of network

anesthesiologist, so that's not covered for us. In addition, now BCBS said they

probably won't cover very much of the neurospect scan either because the

reimursement rate isn't 100% for the provider. Our rep at BCBS said that Dr.

Uszler shouldn't have asked us for the money up front as he is a preferred

provider. If we receive reimbursement at all, it will be minimal. We're still

waiting to hear and we had our scan at the beginning of February. Apparently,

BCBS has been in contact with Dr. Uszler to inform him that he violated BCBS's

policies and their agreement with him by demanding payment upfront. My husband

plans to pursue this with Dr. Uszler once we know how much, if

anything, we'll be receiving from the insurance company. I will never use Dr.

Uszler again.

Cheryl, I'm sorry the news isn't better. Even if Dr. Uszler is listed as a

preferred provider, he's probably still going to ask for the money upfront. When

I first contacted him, I told him about our insurance and said that I'd verified

he was a preferred provider and he said that insurance companies rarely

reimburse for neurospect scans, so he requires the money upfront.

Good luck. I'll let you know if/when we receive any compensation from the

BCBS.

Robyn

Cheryl Lowrance <c.lowrance@...> wrote:

We'll probably be going in for a Spect Scan in a few months so right

now, and I are trying to figure out how to make this as

easy as possible as far as finances go. I've contacted my insurance

co Motion Pic/BS and they've told me that as long as it's ordered by

an MD and is medically necessary, it will be covered. The problem

I'm running into is if Santa Imaging is a BS provider. My

insurance company is saying they are out of network. Dr. Uszler will

be covered, but SMITA will not and they will only cover 70% of the

" allowed " amount. Basically, she told me it's going to cost me a

lot. I can't afford it if it does. Does anyone know if SMITA is or

isn't a BS provider? Anyone with BS been through it already? With a

BS provider she said it would be covered 100%. Of course, Dr. G

won't let us go anywhere else. If we can't afford it, we simply

can't get it done.

Cheryl

[Guest guest]

If you read my post, you already know that I'm in complete agreement with

Kristy. Someone on this list said that they had a neurospect scan ordered by Dr.

G done in Torrance. Maybe they'll weigh in on this thread.

Robyn

Kristy Nardini <krnardini@...> wrote:

I would not recommend Santa Imaging. Does BS give you any other

facilities that can do the Spect? I saw Dr. Amen from the Amen Clinic give a

lecture, and if my son has another spect scan, I will try to have it done

there. Maybe you can get recommendations from other families?

BS did cover part of my son's spect scan. What SMI failed to mention to me

when I set everything up was that the anesthesiologist is a freelancer (did

not find this out until AFTERWARDS) and he wanted $800 cash at the end of

the procedure. Very, very weird.

SMI did not provide any kind of interpretive report, and if I wanted copies

of the images, they were another $45 each.

Kristy

From: [mailto: ] On Behalf Of Cheryl

Lowrance

Sent: Tuesday, June 03, 2008 1:24 PM

Subject: Spect Scan / Blue Shield

We'll probably be going in for a Spect Scan in a few months so right

now, and I are trying to figure out how to make this as

easy as possible as far as finances go. I've contacted my insurance

co Motion Pic/BS and they've told me that as long as it's ordered by

an MD and is medically necessary, it will be covered. The problem

I'm running into is if Santa Imaging is a BS provider. My

insurance company is saying they are out of network. Dr. Uszler will

be covered, but SMITA will not and they will only cover 70% of the

" allowed " amount. Basically, she told me it's going to cost me a

lot. I can't afford it if it does. Does anyone know if SMITA is or

isn't a BS provider? Anyone with BS been through it already? With a

BS provider she said it would be covered 100%. Of course, Dr. G

won't let us go anywhere else. If we can't afford it, we simply

can't get it done.

Cheryl

[Guest guest]

Well, you guys are certainly giving me some hope because right now, I

*can't* go to SMITA. I called and asked if we could go

somewhere else and she said no, it was the only place he would send

us. So if others are going somewhere else, maybe he'll be okay with

us going somewhere else that takes insurance. I simply don't have 3K

lying around to pay anyone up front. Doesn't UCLA, Cedars or St.

Joe's do it?

Cheryl

On Jun 3, 2008, at 3:17 PM, Robyn & Greg Coggins wrote:

> If you read my post, you already know that I'm in complete

> agreement with Kristy. Someone on this list said that they had a

> neurospect scan ordered by Dr. G done in Torrance. Maybe they'll

> weigh in on this thread.

>

> Robyn

>

> Kristy Nardini <krnardini@...> wrote:

> I would not recommend Santa Imaging. Does BS give you any other

> facilities that can do the Spect? I saw Dr. Amen from the Amen

> Clinic give a

> lecture, and if my son has another spect scan, I will try to have

> it done

> there. Maybe you can get recommendations from other families?

>

> BS did cover part of my son's spect scan. What SMI failed to

> mention to me

> when I set everything up was that the anesthesiologist is a

> freelancer (did

> not find this out until AFTERWARDS) and he wanted $800 cash at the

> end of

> the procedure. Very, very weird.

>

> SMI did not provide any kind of interpretive report, and if I

> wanted copies

> of the images, they were another $45 each.

>

> Kristy

>

> From: [mailto: ] On Behalf

> Of Cheryl

> Lowrance

> Sent: Tuesday, June 03, 2008 1:24 PM

>

> Subject: Spect Scan / Blue Shield

>

> We'll probably be going in for a Spect Scan in a few months so right

> now, and I are trying to figure out how to make this as

> easy as possible as far as finances go. I've contacted my insurance

> co Motion Pic/BS and they've told me that as long as it's ordered by

> an MD and is medically necessary, it will be covered. The problem

> I'm running into is if Santa Imaging is a BS provider. My

> insurance company is saying they are out of network. Dr. Uszler will

> be covered, but SMITA will not and they will only cover 70% of the

> " allowed " amount. Basically, she told me it's going to cost me a

> lot. I can't afford it if it does. Does anyone know if SMITA is or

> isn't a BS provider? Anyone with BS been through it already? With a

> BS provider she said it would be covered 100%. Of course, Dr. G

> won't let us go anywhere else. If we can't afford it, we simply

> can't get it done.

>

> Cheryl

>

>

[Guest guest]

I've been trying to find the place in Torrance that I heard about on the

listserv. I've googled but nothing comes up. I think it was Doris who used

the facility for a spect scan. Hopefully, she'll weigh in on this. I do believe

UCLA has a facility as well.

I wonder why it has to be Dr. Uszler? If we have to do it again, I won't use

him unless we get this financial issue resolved. It's frustrating to have

insurance and then have a preferred provider refuse it! If you don't want to be

a preferred provider then don't be a preferred provider, but don't leave the

patient holding the entire $2,500 bag.

We had to raid our savings account to pay for it and I was hoping to put at

least some of that money back.

Anyway, that's my rant for today. If I can remember the name of the clinic in

Torrance, I'll let you know.

All the best,

Robyn

Cheryl Lowrance <c.lowrance@...> wrote:

Well, you guys are certainly giving me some hope because right now, I

*can't* go to SMITA. I called and asked if we could go

somewhere else and she said no, it was the only place he would send

us. So if others are going somewhere else, maybe he'll be okay with

us going somewhere else that takes insurance. I simply don't have 3K

lying around to pay anyone up front. Doesn't UCLA, Cedars or St.

Joe's do it?

Cheryl

On Jun 3, 2008, at 3:17 PM, Robyn & Greg Coggins wrote:

> If you read my post, you already know that I'm in complete

> agreement with Kristy. Someone on this list said that they had a

> neurospect scan ordered by Dr. G done in Torrance. Maybe they'll

> weigh in on this thread.

>

> Robyn

>

> Kristy Nardini <krnardini@...> wrote:

> I would not recommend Santa Imaging. Does BS give you any other

> facilities that can do the Spect? I saw Dr. Amen from the Amen

> Clinic give a

> lecture, and if my son has another spect scan, I will try to have

> it done

> there. Maybe you can get recommendations from other families?

>

> BS did cover part of my son's spect scan. What SMI failed to

> mention to me

> when I set everything up was that the anesthesiologist is a

> freelancer (did

> not find this out until AFTERWARDS) and he wanted $800 cash at the

> end of

> the procedure. Very, very weird.

>

> SMI did not provide any kind of interpretive report, and if I

> wanted copies

> of the images, they were another $45 each.

>

> Kristy

>

> From: [mailto: ] On Behalf

> Of Cheryl

> Lowrance

> Sent: Tuesday, June 03, 2008 1:24 PM

>

> Subject: Spect Scan / Blue Shield

>

> We'll probably be going in for a Spect Scan in a few months so right

> now, and I are trying to figure out how to make this as

> easy as possible as far as finances go. I've contacted my insurance

> co Motion Pic/BS and they've told me that as long as it's ordered by

> an MD and is medically necessary, it will be covered. The problem

> I'm running into is if Santa Imaging is a BS provider. My

> insurance company is saying they are out of network. Dr. Uszler will

> be covered, but SMITA will not and they will only cover 70% of the

> " allowed " amount. Basically, she told me it's going to cost me a

> lot. I can't afford it if it does. Does anyone know if SMITA is or

> isn't a BS provider? Anyone with BS been through it already? With a

> BS provider she said it would be covered 100%. Of course, Dr. G

> won't let us go anywhere else. If we can't afford it, we simply

> can't get it done.

>

> Cheryl

>

>

[Guest guest]

From what I hear the Torrance location is closed

On Jun 3, 2008, at 3:17 PM, Robyn & Greg Coggins wrote:

> If you read my post, you already know that I'm in complete agreement

> with Kristy. Someone on this list said that they had a neurospect

> scan ordered by Dr. G done in Torrance. Maybe they'll weigh in on

> this thread.

>

> Robyn

>

> Kristy Nardini <krnardini@...> wrote:

> I would not recommend Santa Imaging. Does BS give you any other

> facilities that can do the Spect? I saw Dr. Amen from the Amen

> Clinic give a

> lecture, and if my son has another spect scan, I will try to have it

> done

> there. Maybe you can get recommendations from other families?

>

> BS did cover part of my son's spect scan. What SMI failed to mention

> to me

> when I set everything up was that the anesthesiologist is a

> freelancer (did

> not find this out until AFTERWARDS) and he wanted $800 cash at the

> end of

> the procedure. Very, very weird.

>

> SMI did not provide any kind of interpretive report, and if I wanted

> copies

> of the images, they were another $45 each.

>

> Kristy

>

> From: [mailto: ] On Behalf

> Of Cheryl

> Lowrance

> Sent: Tuesday, June 03, 2008 1:24 PM

>

> Subject: Spect Scan / Blue Shield

>

> We'll probably be going in for a Spect Scan in a few months so right

> now, and I are trying to figure out how to make this as

> easy as possible as far as finances go. I've contacted my insurance

> co Motion Pic/BS and they've told me that as long as it's ordered by

> an MD and is medically necessary, it will be covered. The problem

> I'm running into is if Santa Imaging is a BS provider. My

> insurance company is saying they are out of network. Dr. Uszler will

> be covered, but SMITA will not and they will only cover 70% of the

> " allowed " amount. Basically, she told me it's going to cost me a

> lot. I can't afford it if it does. Does anyone know if SMITA is or

> isn't a BS provider? Anyone with BS been through it already? With a

> BS provider she said it would be covered 100%. Of course, Dr. G

> won't let us go anywhere else. If we can't afford it, we simply

> can't get it done.

>

> Cheryl

>

>

[Guest guest]

I thought it was Brain Matters at the UCLA Harbor Medical Center, but

they don't take insurance either.

> > I would not recommend Santa Imaging. Does BS give you any

other

> > facilities that can do the Spect? I saw Dr. Amen from the Amen

> > Clinic give a

> > lecture, and if my son has another spect scan, I will try to have

> > it done

> > there. Maybe you can get recommendations from other families?

> >

> > BS did cover part of my son's spect scan. What SMI failed to

> > mention to me

> > when I set everything up was that the anesthesiologist is a

> > freelancer (did

> > not find this out until AFTERWARDS) and he wanted $800 cash at

the

> > end of

> > the procedure. Very, very weird.

> >

> > SMI did not provide any kind of interpretive report, and if I

> > wanted copies

> > of the images, they were another $45 each.

> >

> > Kristy

> >

> > From: [mailto: ] On

Behalf

> > Of Cheryl

> > Lowrance

> > Sent: Tuesday, June 03, 2008 1:24 PM

> >

> > Subject: Spect Scan / Blue Shield

> >

> > We'll probably be going in for a Spect Scan in a few months so

right

> > now, and I are trying to figure out how to make this as

> > easy as possible as far as finances go. I've contacted my

insurance

> > co Motion Pic/BS and they've told me that as long as it's ordered

by

> > an MD and is medically necessary, it will be covered. The problem

> > I'm running into is if Santa Imaging is a BS provider. My

> > insurance company is saying they are out of network. Dr. Uszler

will

> > be covered, but SMITA will not and they will only cover 70% of the

> > " allowed " amount. Basically, she told me it's going to cost me a

> > lot. I can't afford it if it does. Does anyone know if SMITA is or

> > isn't a BS provider? Anyone with BS been through it already? With

a

> > BS provider she said it would be covered 100%. Of course, Dr. G

> > won't let us go anywhere else. If we can't afford it, we simply

> > can't get it done.

> >

> > Cheryl

> >

> >

[Guest guest]

In 1991-1992 my three daughters had over 6 spect scans each and blue shield paid

for all of them. My daughter age 4 was autistic, non verbal with autoimmune

disorders as a lupus like disorder, with joint pain etc.. My older daughter age

6 had gran mal sz, with a sceloderma like disorder, My youngest daughter age 2

had abnormal brain spect scan with positive Ana autoimmune disorder. All of them

are fine now attending school and working. Ages now are 22, 20 and 18. We later

had the scans re read with no problems from the insurance company. These scan

we done pre and post treatments.

We have and still have Blue shield of california Federal emplyee program, and

also Blue Cross PPO again this was in 1991 to 1992 so I hope they still pay for

your children.

R,

I am new to this group.

Spect Scan / Blue Shield

> >

> > We'll probably be going in for a Spect Scan in a few months so

right

> > now, and I are trying to figure out how to make this as

> > easy as possible as far as finances go. I've contacted my

insurance

> > co Motion Pic/BS and they've told me that as long as it's ordered

by

> > an MD and is medically necessary, it will be covered. The problem

> > I'm running into is if Santa Imaging is a BS provider. My

> > insurance company is saying they are out of network. Dr. Uszler

will

> > be covered, but SMITA will not and they will only cover 70% of the

> > " allowed " amount. Basically, she told me it's going to cost me a

> > lot. I can't afford it if it does. Does anyone know if SMITA is or

> > isn't a BS provider? Anyone with BS been through it already? With

a

> > BS provider she said it would be covered 100%. Of course, Dr. G

> > won't let us go anywhere else. If we can't afford it, we simply

> > can't get it done.

> >

> > Cheryl

> >

> >

[Guest guest]

,

I hope you don't mind answering a couple of questions. Your older

daughter, with the joint pain. How did you treat it? How is she

doing today?

Thank you,

Argie

On Jun 4, 2008, at 9:19 PM, SUSAN RODRIGUEZ wrote:

> In 1991-1992 my three daughters had over 6 spect scans each and blue

> shield paid for all of them. My daughter age 4 was autistic, non

> verbal with autoimmune disorders as a lupus like disorder, with

> joint pain etc.. My older daughter age 6 had gran mal sz, with a

> sceloderma like disorder, My youngest daughter age 2 had abnormal

> brain spect scan with positive Ana autoimmune disorder. All of them

> are fine now attending school and working. Ages now are 22, 20 and

> 18. We later had the scans re read with no problems from the

> insurance company. These scan we done pre and post treatments.

> We have and still have Blue shield of california Federal emplyee

> program, and also Blue Cross PPO again this was in 1991 to 1992 so I

> hope they still pay for your children.

> R,

> I am new to this group.

> Spect Scan / Blue Shield

> > >

> > > We'll probably be going in for a Spect Scan in a few months so

> right

> > > now, and I are trying to figure out how to make this as

> > > easy as possible as far as finances go. I've contacted my

> insurance

> > > co Motion Pic/BS and they've told me that as long as it's ordered

> by

> > > an MD and is medically necessary, it will be covered. The problem

> > > I'm running into is if Santa Imaging is a BS provider. My

> > > insurance company is saying they are out of network. Dr. Uszler

> will

> > > be covered, but SMITA will not and they will only cover 70% of the

> > > " allowed " amount. Basically, she told me it's going to cost me a

> > > lot. I can't afford it if it does. Does anyone know if SMITA is or

> > > isn't a BS provider? Anyone with BS been through it already? With

> a

> > > BS provider she said it would be covered 100%. Of course, Dr. G

> > > won't let us go anywhere else. If we can't afford it, we simply

> > > can't get it done.

> > >

> > > Cheryl

> > >

> > >

[Guest guest]

My answer is rather long, I dont want to over step my bounds, May I write you

off the list?

Spect Scan / Blue Shield

> > >

> > > We'll probably be going in for a Spect Scan in a few months so

> right

> > > now, and I are trying to figure out how to make this as

> > > easy as possible as far as finances go. I've contacted my

> insurance

> > > co Motion Pic/BS and they've told me that as long as it's ordered

> by

> > > an MD and is medically necessary, it will be covered. The problem

> > > I'm running into is if Santa Imaging is a BS provider. My

> > > insurance company is saying they are out of network. Dr. Uszler

> will

> > > be covered, but SMITA will not and they will only cover 70% of the

> > > " allowed " amount. Basically, she told me it's going to cost me a

> > > lot. I can't afford it if it does. Does anyone know if SMITA is or

> > > isn't a BS provider? Anyone with BS been through it already? With

> a

> > > BS provider she said it would be covered 100%. Of course, Dr. G

> > > won't let us go anywhere else. If we can't afford it, we simply

> > > can't get it done.

> > >

> > > Cheryl

> > >

> > >

[Guest guest]

Yes, please do.

Thanks!

golivo@...

On Jun 5, 2008, at 2:53 PM, Rapid Recovery Hyperbarics wrote:

> My answer is rather long, I dont want to over step my bounds, May I

> write you off the list?

>

> Spect Scan / Blue Shield

> > > >

> > > > We'll probably be going in for a Spect Scan in a few months so

> > right

> > > > now, and I are trying to figure out how to make this

> as

> > > > easy as possible as far as finances go. I've contacted my

> > insurance

> > > > co Motion Pic/BS and they've told me that as long as it's

> ordered

> > by

> > > > an MD and is medically necessary, it will be covered. The

> problem

> > > > I'm running into is if Santa Imaging is a BS provider. My

> > > > insurance company is saying they are out of network. Dr. Uszler

> > will

> > > > be covered, but SMITA will not and they will only cover 70% of

> the

> > > > " allowed " amount. Basically, she told me it's going to cost me a

> > > > lot. I can't afford it if it does. Does anyone know if SMITA

> is or

> > > > isn't a BS provider? Anyone with BS been through it already?

> With

> > a

> > > > BS provider she said it would be covered 100%. Of course, Dr. G

> > > > won't let us go anywhere else. If we can't afford it, we simply

> > > > can't get it done.

> > > >

> > > > Cheryl

> > > >

> > > >