Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 I don't think it is going to get any better, either. My friend here, previously implanted, is on disability. Her Internist called 5 Endocrinologist's offices before he could find one who would take her Medicare and secondary policy... Cathie In a message dated 1/9/08 10:43:05 AM, lisatucholski@... writes: These companies are amazing at the loop holes they find to deny coverage. My husband has been an employee of Cigna healthcare for the past 8 years. I don't remember where i saw the article, it may have been on this site but a few weeks ago a story broke about Cigna and how they denied coverage for an organ transplant for a young girl and untimely she did end up dying. All of the employees got an email that night trying to explain their decision and how the media made it worse then what it was. My husband works for one of the top healthcare companies in Philadelphia and we are on my company insurance because Cigna's coverage is so horrible but yet his contributions are higher then what i pay. They are literally getting away with murder! **************Start the year off right. Easy ways to stay in shape. http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 These companies are amazing at the loop holes they find to deny coverage. My husband has been an employee of Cigna healthcare for the past 8 years. I don't remember where i saw the article, it may have been on this site but a few weeks ago a story broke about Cigna and how they denied coverage for an organ transplant for a young girl and untimely she did end up dying. All of the employees got an email that night trying to explain their decision and how the media made it worse then what it was. My husband works for one of the top healthcare companies in Philadelphia and we are on my company insurance because Cigna's coverage is so horrible but yet his contributions are higher then what i pay. They are literally getting away with murder! > > They say implants don't cause problems, but then when there are problems, > they don't want to cover them... I wonder if anyone has sued over this yet... > > I have racked my brain trying to figure out some way to bring all of this to > a head, but am at a loss. The only thing I can think of that might be looked > at with some merit, would be a study of the number of people on disability due > to problems, not just w/breast implants, but other forms of silicone related > materials... I think they even have a diagnosis code for this with SS. > > And now, with the ID chips for animals causing problems, I wonder if this > might make researchers more likely to look at the issue again... > Cathie > > > > ************** > Start the year off right. Easy ways to stay in shape. > > http://body.aol.com/fitness/winter-exercise? NCID=aolcmp00300000002489 > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 These companies are amazing at the loop holes they find to deny coverage. My husband has been an employee of Cigna healthcare for the past 8 years. I don't remember where i saw the article, it may have been on this site but a few weeks ago a story broke about Cigna and how they denied coverage for an organ transplant for a young girl and untimely she did end up dying. All of the employees got an email that night trying to explain their decision and how the media made it worse then what it was. My husband works for one of the top healthcare companies in Philadelphia and we are on my company insurance because Cigna's coverage is so horrible but yet his contributions are higher then what i pay. They are literally getting away with murder! > > They say implants don't cause problems, but then when there are problems, > they don't want to cover them... I wonder if anyone has sued over this yet... > > I have racked my brain trying to figure out some way to bring all of this to > a head, but am at a loss. The only thing I can think of that might be looked > at with some merit, would be a study of the number of people on disability due > to problems, not just w/breast implants, but other forms of silicone related > materials... I think they even have a diagnosis code for this with SS. > > And now, with the ID chips for animals causing problems, I wonder if this > might make researchers more likely to look at the issue again... > Cathie > > > > ************** > Start the year off right. Easy ways to stay in shape. > > http://body.aol.com/fitness/winter-exercise? NCID=aolcmp00300000002489 > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2008 Report Share Posted January 9, 2008 which makes you wonder how many doctors are really in it to help people. You could walk in there with an organ hanging out and they would ask for your insurance card before anything. > > I don't think it is going to get any better, either. My friend here, > previously implanted, is on disability. Her Internist called 5 Endocrinologist's > offices before he could find one who would take her Medicare and secondary > policy... > Cathie > In a message dated 1/9/08 10:43:05 AM, lisatucholski@... writes: > > > > > > These companies are amazing at the loop holes they find to deny > > coverage. My husband has been an employee of Cigna healthcare for > > the past 8 years. I don't remember where i saw the article, it may > > have been on this site but a few weeks ago a story broke about Cigna > > and how they denied coverage for an organ transplant for a young > > girl and untimely she did end up dying. All of the employees got an > > email that night trying to explain their decision and how the media > > made it worse then what it was. My husband works for one of the top > > healthcare companies in Philadelphia and we are on my company > > insurance because Cigna's coverage is so horrible but yet his > > contributions are higher then what i pay. They are literally getting > > away with murder! > > > > > > > > > > > ************** > Start the year off right. Easy ways to stay in shape. > > http://body.aol.com/fitness/winter-exercise? NCID=aolcmp00300000002489 > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 21, 2008 Report Share Posted March 21, 2008 Same with midwives... my Insurance Co. doesn't cover midwives, so I shelled out the $3,100.00 for her myself, but if I were to see an (in-network) OB for the birth my my child, I'd only have to pay a TOTAL of $200.00 out of pocket for the entire thing... ALL visits, and anything associated with a hospital birth. I started out with a mainstream OB for my first child, and was pushed through that office in a matter of MINUTES at each visit. The visits got shorter and shorter when I refused all the testing they wanted to do on me to rule out birth defects (multiple ultrasounds, bloodwork, and they even suggested I get an amniocentisis... the only reason was because I was 35 years old!) Because the outcome of those tests was not going to change whether I elected to continue with the birth of my child or not, I didn't find them necessary, therefore the OB didn't find it necessary to provide any worthwhile care. I got fed up and found a homebirth midwife for the first one, too. My insurance co has also refused to cover accupuncture as part of my prenatal care. So far my chiropractic care has been covered, thankfully! I don't know how I would have made it through my 3rd trimester without my chiro! On Fri, Mar 21, 2008 at 12:37 PM, Randi Airola <randiceaj@...> wrote: > > My kids see a holistic doctor that doesn't push vacc's down my throat. Today > in the mail, I got a disturbing post card from the doctor stating that our > insurance carrier was dropping him as a PPO. > > I called to ask what was going on, and was informed that he was being > dropped as a PPO because " he spends too much time with his patients. His > colleagues (must be mainstream) can do an appt. in 15 minutes and because > his averages an hour, they were losing money on him. > > And one wonders why when they go to their mainstream doctor their shoved in > and out like cattle and are pushed vaccines for " preventable diseases " . > (must be an insurance requirement) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 21, 2008 Report Share Posted March 21, 2008 You may be able to keep him, and just get reimbursed. For example, you go to him. You pay the full price. You send an insurance company form, and they will reimburse you for the cost that they would have incurred had you gone to an in-network doctor. You won't get all of your money back, but you will get some. I had an insurance company do this for a doctor I saw who simply did not take insurance. It would have cost him too much, and he was a specialist with a small practice. He provided the forms for his patients to get reimbursements from their insurance, but we had to fill them out and wait. I loved the doctor, so I was fine with it. I have a friend who loved medicine, and would probably make a great health-care practitioner, but after finding out how much of his life would be dictated by insurance companies, he changed his mind. ~Robyn Randi Airola wrote: > > My kids see a holistic doctor that doesn't push vacc's down my throat. > Today in the mail, I got a disturbing post card from the doctor > stating that our insurance carrier was dropping him as a PPO. > > I called to ask what was going on, and was informed that he was being > dropped as a PPO because " he spends too much time with his patients. > His colleagues (must be mainstream) can do an appt. in 15 minutes and > because his averages an hour, they were losing money on him. > > And one wonders why when they go to their mainstream doctor their > shoved in and out like cattle and are pushed vaccines for " preventable > diseases " . (must be an insurance requirement) > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 21, 2008 Report Share Posted March 21, 2008 health-care practitioner, but after finding out how much of his life would be dictated by insurance companies, he changed his mind. ~Robyn this is true. They dictate a lot. My OB used to do your Pap smear on the 6 week visit if you needed one and now he can’t b/c insurance changed the rules.. so I’m very overdue but I have go in may now b/c of insurance. They drive me nuts---but I’m glad to have it. The birth would have been way expensive w/o it! Nita, Mom to: 14, Jon 13, 10, 8, 6, Christian (7/16/03 to 8/22/04), 2 and Isaac, 2/308 Learn from the mistakes of others. Trust me... you can't live long enough to make them all yourself. No virus found in this incoming message. Checked by AVG. Version: 7.5.519 / Virus Database: 269.21.8/1337 - Release Date: 3/20/2008 8:10 PM No virus found in this outgoing message. Checked by AVG. Version: 7.5.519 / Virus Database: 269.21.8/1337 - Release Date: 3/20/2008 8:10 PM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 22, 2008 Report Share Posted March 22, 2008 I can still keep him, he's covered under BCBS, what I found appalling was their reasoning of dropping him as a PPO. (spending too much time with his patients). To me, this is one of the cornerstones of all things gone awry. Even if he werent' part of BCBS, I'd take my kids to him anyway regardless of the cost, as it seems that considering he spends too much time with his patients, he's the only one that truly cares. I'll take the higher payment vs. mainstream (with a whopping 15 minutes) that only wants to shove medications at me. No thank you.... ---------------------- You may be able to keep him, and just get reimbursed. For example, you go to him. You pay the full price. You send an insurance company form, and they will reimburse you for the cost that they would have incurred had you gone to an in-network doctor. You won't get all of your money back, but you will get some. I had an insurance company do this for a doctor I saw who simply did not take insurance. It would have cost him too much, and he was a specialist with a small practice. He provided the forms for his patients to get reimbursements from their insurance, but we had to fill them out and wait. I loved the doctor, so I was fine with it. I have a friend who loved medicine, and would probably make a great health-care practitioner, but after finding out how much of his life would be dictated by insurance companies, he changed his mind. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2008 Report Share Posted November 8, 2008 Barb, I have found over the years with insurance companies the thing you have to do is outlast them. They are trying to wear you down in hopes that you will go away. Kind of like our kids when they were little and before Dr. G. Don't let either of them win. I even got the insurance company to pay for our ABA specialist we flew in to Minnesota when was little. Of course I didn't have time to go after them for that until he was somewhat better. I wrote them over and over again for 6 months with no success. ( Put everything in writing.) Then I hired an attorney to write one letter and that was all it took. I guess they thought it was cheaper to pay than face legal action. Hope it works for you. Marcia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2008 Report Share Posted November 8, 2008 thanks, Marcia. I will do all I can do, but this insurance company seems really tough. Barb Katsaros barbkatsaros@... From: and Marcia Hinds <hindssite@...> Subject: Insurance companies barbkatsaros@..., Date: Saturday, November 8, 2008, 8:07 AM Barb, I have found over the years with insurance companies the thing you have to do is outlast them. They are trying to wear you down in hopes that you will go away. Kind of like our kids when they were little and before Dr. G. Don't let either of them win. I even got the insurance company to pay for our ABA specialist we flew in to Minnesota when was little. Of course I didn't have time to go after them for that until he was somewhat better. I wrote them over and over again for 6 months with no success. ( Put everything in writing.) Then I hired an attorney to write one letter and that was all it took. I guess they thought it was cheaper to pay than face legal action. Hope it works for you. Marcia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2009 Report Share Posted January 6, 2009 I’d ask the Insurance Division to investigate an Unfair Claims Settlement Practices Act violation for misrepresenting the policy provisions and see what they do with it. There was an OPB story in the last week or two dealing with a similar issue where the health insurer would issue a denial letter and request for additional info instead of merely asking for the additional info they needed…I was quite surprised to hear that the Insurance Division imposed a fine on the company for the denial. Chris T. Hill, PC 520 SW Sixth Avenue, Suite 1250 Portland, OR 97204 (503) 227-4330 chill@... From: [mailto: ] On Behalf Of bradrethwilldc Sent: Tuesday, January 06, 2009 2:08 PM Subject: Insurance companies Is anyone else seeing a trend with insurance companies where my insurance clerk calls to verify coverage, the insurance co. says that the pt. has no chiro. beneftis, but when you bill the insurance co. the benefit is paid? BTW, these ins. companies usually have had chiro. benefits in the past. Brad Rethwill, DC Eugene, OR Quote Link to comment Share on other sites More sharing options...
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