RE: [SPAM] insurance issues

[Guest guest]

No, sorry.

Patti Sweetman

909.374.9121

_____

From: [mailto: ] On Behalf Of

Sent: Friday, September 19, 2008 11:06 PM

Subject: [sPAM] insurance issues

Has anyone had success in getting their insurance to cover Dr. G as

an " in-network provider " ? We have Anthem Blue Cross.

Thank you,

[Guest guest]

Hi Pattie-

Usually the only way to get Anthem to cover someone as an in-network provider is

to request a " single case agreement " (may not be called that exactly), or to ask

for a " gap request " - usually for when you can't get an in-network provider in

your location (not as common).   For a single case agreement, the doctor usually

gets a fax requesting that they accept the in-network payment and write off the

rest.  Dr G isn't usually going to do that - they often request to reduce a bill

by almost half, and they will discount it down to approximately $45-$65 - ok if

you're talking about a 5-10 minute office visit, but not for higher level office

visits.

 

Another option is a letter trying to make a persuasive case that your child has

immune dysfunction resulting in cognitive dysfunction - see the pediatric

definition of CFS by googling - and that very few physicians have any expertise

in Chronic Fatigue Syndome or Immune Dysfunction, and that Dr Goldberg

specializes in it as a pediatrician.

 

It's hard to get this accomplished.  It works better if you have impressive

enough findings of immune issues in labs - not common to .  If there is a

history of chronic infections, that could help.  Any medical history you'd like

to share with me, I can let you know if there is anything that could stand out.

 

HTH-

[sPAM] insurance issues

Has anyone had success in getting their insurance to cover Dr. G as

an " in-network provider " ? We have Anthem Blue Cross.

Thank you,