Re: Re: Insurance reimbursement

[Guest guest]

Suzanne,

I had Cigna and they originally said they would not pay. I went ahead and paid

for the surgery, then filed an appeal letter. They then agreed to pay out of

network for my surgery. This was in May of 2000 and I am in Indiana. I have a

friend who works at the same place I do, had the same insurance, and she is

still fighting them to pay. She has gotten some reimbursement, but not much.

Hope this helps

Elaine

-- Re: Insurance Reimbursement

>

> Audrey,

I am with you. I have pre-auth before surgery and everything and they are

denying it now and I have really had a major run around with them. Well

technically, they still have not denied it but are just letting my claim

sit

and telling me that it probably will be denied. I have Cigna HealthCare.

Please let me know if you find anything out that will help and I will do

the

same for you. You can email me privately at sneighbors@.... I

also

would like to know if there is anyone out there who has Cigna and they

paid

for the surgery.

Thanks,

Suzanne

01/24/03

Re: Insurance Reimbursement

> Mike, who did you contact at ?? I am in appeals with my insurance

company and would like to get an itemized statement to send with the

appeals

paperwork! Did you get some type of extra information from Dr. R's

office?

I remember reading in one of these e-mails that you could get an appeals

letter from the office, does anyone know if that is true?? Thanks for

what

ever help you can offer, I am 1 year this month and am still struggling

with

the insurance company even tho the pre-approved the surgery

pre-operatively!! Thanks, Audry

>

> >>> braunmk@... 07/02/03 02:43AM >>>

> IBM's United Healthcare POS approved and paid my claim. I followed

their

> process of pre-approval fully and they just paid 90% of $17,000. It

took

10

> months and a ton of phone calls to overcome the system, but in the end,

they paid.

> I got the detailed records from the billing department at Medical

> Center and included it with my invoice. UHC lost my submission twice

and

gave me

> the typical runaround. I recommend that you keep a record of every bit

of

> correspondence and resubmit citing examples of others whose applications

were

> accepted. Good luck and remain persistent.

>

> Mike Braun, Towson, MD

> August 19, 2002 334/232

>

>

>

[Guest guest]

Elaine,

I was wondering if you could give me more details on what you had to do to

get them to pay out of network at least. How long did your process take?

Thanks very much,

Suzanne

Re: Insurance Reimbursement

>

>

> > Mike, who did you contact at ?? I am in appeals with my insurance

> company and would like to get an itemized statement to send with the

> appeals

> paperwork! Did you get some type of extra information from Dr. R's

> office?

> I remember reading in one of these e-mails that you could get an appeals

> letter from the office, does anyone know if that is true?? Thanks for

> what

> ever help you can offer, I am 1 year this month and am still struggling

> with

> the insurance company even tho the pre-approved the surgery

> pre-operatively!! Thanks, Audry

> >

> > >>> braunmk@... 07/02/03 02:43AM >>>

> > IBM's United Healthcare POS approved and paid my claim. I followed

> their

> > process of pre-approval fully and they just paid 90% of $17,000. It

> took

> 10

> > months and a ton of phone calls to overcome the system, but in the end,

> they paid.

> > I got the detailed records from the billing department at Medical

> > Center and included it with my invoice. UHC lost my submission twice

> and

> gave me

> > the typical runaround. I recommend that you keep a record of every bit

> of

> > correspondence and resubmit citing examples of others whose applications

> were

> > accepted. Good luck and remain persistent.

> >

> > Mike Braun, Towson, MD

> > August 19, 2002 334/232

> >

> >

> >

[Guest guest]

Suzanne,

First I got a letter from Dr. R's office that had all kinds of statistics and

technical jargon. Then I wrote a personal letter to CIGNA. I detailed all the

diets I could think of that I was on, how obesity affected me most of my life,

how obesity ran in my family, health problems in my family, my health problems,

how hard it was to do little things like get up off the floor after playing with

my grandchildren. I made it very personal. It was a kind of cleansing

experience also. I was crying my eyes out by the time I finished. I wanted

them to know me, and how much this surgery meant to me, and how now I felt I had

a fighting chance to live a long, productive life.

I sent all this in a packet to CIGNA. It took a few weeks before they decided

to pay. Even then, it took almost 5 months to get all my money. It was worth

it, though. In the end, they paid almost 100%. When I had my surgery, I got a

25% deduction for paying cash from both Dr. R and the hospital. CIGNA had to

pay based on what the surgery originally was, so I really lucked out.

If you want, email me privately, and I might still have my appeal letter that I

could send you if that would help.

Let me know, and good luck.

Elaine

-- Re: Re: Insurance Reimbursement

>

> Elaine,

I was wondering if you could give me more details on what you had to do to

get them to pay out of network at least. How long did your process take?

Thanks very much,

Suzanne

Re: Insurance Reimbursement

>

>

> > Mike, who did you contact at ?? I am in appeals with my insurance

> company and would like to get an itemized statement to send with the

> appeals

> paperwork! Did you get some type of extra information from Dr. R's

> office?

> I remember reading in one of these e-mails that you could get an appeals

> letter from the office, does anyone know if that is true?? Thanks for

> what

> ever help you can offer, I am 1 year this month and am still struggling

> with

> the insurance company even tho the pre-approved the surgery

> pre-operatively!! Thanks, Audry

> >

> > >>> braunmk@... 07/02/03 02:43AM >>>

> > IBM's United Healthcare POS approved and paid my claim. I followed

> their

> > process of pre-approval fully and they just paid 90% of $17,000. It

> took

> 10

> > months and a ton of phone calls to overcome the system, but in the

end,

> they paid.

> > I got the detailed records from the billing department at

Medical

> > Center and included it with my invoice. UHC lost my submission twice

> and

> gave me

> > the typical runaround. I recommend that you keep a record of every

bit

> of

> > correspondence and resubmit citing examples of others whose

applications

> were

> > accepted. Good luck and remain persistent.

> >

> > Mike Braun, Towson, MD

> > August 19, 2002 334/232

> >

> >

> >

[Guest guest]

Elaine, What aan insperation you are I would love to have a copy of your

appeal letter as my ins. co. are refusing to pay. They told me to appeal. A

successful appeal letter outline to follow might just do the trick. thanks

so much,

Re: Insurance Reimbursement

> >

> >

> > > Mike, who did you contact at ?? I am in appeals with my insurance

> > company and would like to get an itemized statement to send with the

> > appeals

> > paperwork! Did you get some type of extra information from Dr. R's

> > office?

> > I remember reading in one of these e-mails that you could get an appeals

> > letter from the office, does anyone know if that is true?? Thanks for

> > what

> > ever help you can offer, I am 1 year this month and am still struggling

> > with

> > the insurance company even tho the pre-approved the surgery

> > pre-operatively!! Thanks, Audry

> > >

> > > >>> braunmk@... 07/02/03 02:43AM >>>

> > > IBM's United Healthcare POS approved and paid my claim. I followed

> > their

> > > process of pre-approval fully and they just paid 90% of $17,000. It

> > took

> > 10

> > > months and a ton of phone calls to overcome the system, but in the

> end,

> > they paid.

> > > I got the detailed records from the billing department at

> Medical

> > > Center and included it with my invoice. UHC lost my submission twice

> > and

> > gave me

> > > the typical runaround. I recommend that you keep a record of every

> bit

> > of

> > > correspondence and resubmit citing examples of others whose

> applications

> > were

> > > accepted. Good luck and remain persistent.

> > >

> > > Mike Braun, Towson, MD

> > > August 19, 2002 334/232

> > >

> > >

> > >

[Guest guest]

Elaine,

Would you please send me a copy of the letter you sent to the ins. co.

I to need the help to fight to get them to pay.

Thank- you.

JoAnn

jkb@...

Re: Insurance Reimbursement

> >

> >

> > > Mike, who did you contact at ?? I am in appeals with my insurance

> > company and would like to get an itemized statement to send with the

> > appeals

> > paperwork! Did you get some type of extra information from Dr. R's

> > office?

> > I remember reading in one of these e-mails that you could get an appeals

> > letter from the office, does anyone know if that is true?? Thanks for

> > what

> > ever help you can offer, I am 1 year this month and am still struggling

> > with

> > the insurance company even tho the pre-approved the surgery

> > pre-operatively!! Thanks, Audry

> > >

> > > >>> braunmk@... 07/02/03 02:43AM >>>

> > > IBM's United Healthcare POS approved and paid my claim. I followed

> > their

> > > process of pre-approval fully and they just paid 90% of $17,000. It

> > took

> > 10

> > > months and a ton of phone calls to overcome the system, but in the

> end,

> > they paid.

> > > I got the detailed records from the billing department at

> Medical

> > > Center and included it with my invoice. UHC lost my submission twice

> > and

> > gave me

> > > the typical runaround. I recommend that you keep a record of every

> bit

> > of

> > > correspondence and resubmit citing examples of others whose

> applications

> > were

> > > accepted. Good luck and remain persistent.

> > >

> > > Mike Braun, Towson, MD

> > > August 19, 2002 334/232

> > >

> > >

> > >

[Guest guest]

Whose your carrier?

cheryl

On Apr 6, 2008, at 6:08 PM, jj2littletrojans wrote:

> Ours actually paid for a little while. It paid under major medical

> once the boys had met their deductible. However, they recently stopped

> paying, so I've got to call and ask why.

>

>

>

>

> >

> > Has anyone been successful in getting reimbursed for phone consult

> > visits?

> >

>

>

>

[Guest guest]

If you are having trouble with your Ins. paying for service, check out this web

page. The are laws in place to help us gets the services needed for our children

for life.

http://www.insurancehelpforautism.com/index.html

Re: Insurance reimbursement

Ours actually paid for a little while. It paid under major medical

once the boys had met their deductible. However, they recently stopped

paying, so I've got to call and ask why.

>

> Has anyone been successful in getting reimbursed for phone consult

> visits?

>

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