Guest guest Posted July 30, 2010 Report Share Posted July 30, 2010 WOW!! Thanks for the notice!! Sent on the Sprint® Now Network from my BlackBerry® Telephone consult $ Just a heads up - telephone consults have been increased to $205 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 30, 2010 Report Share Posted July 30, 2010 Yep - we just got the notice in our monthly statement $205. First increase since 2004. They are getting squeezed by insurance co's like all of us _____ From: [mailto: ] On Behalf Of Doris and Steve Sent: Friday, July 30, 2010 10:26 AM Subject: Telephone consult $ Just a heads up - telephone consults have been increased to $205 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 31, 2010 Report Share Posted July 31, 2010 Hi Do you get the telephone consults covered by your insurance? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 1, 2010 Report Share Posted August 1, 2010 Dr. G doesn't take insurance!!! How can they feel the squeeze when they only take insurance from one company? Pass the costs on to those who use their insurance! Kristy Nardini TazziniTM Stainless Steel Bottles <http://www.tazzini.com/> http://www.tazzini.com kristy@... Phone: 858.243.1929 Fax: 858.724.1418 P Please consider the environment before printing this email. From: [mailto: ] On Behalf Of Crosss Sent: Friday, July 30, 2010 3:21 PM Subject: RE: Telephone consult $ Yep - we just got the notice in our monthly statement $205. First increase since 2004. They are getting squeezed by insurance co's like all of us _____ From: <mailto:%40> [mailto: <mailto:%40> ] On Behalf Of Doris and Steve Sent: Friday, July 30, 2010 10:26 AM Subject: Telephone consult $ Just a heads up - telephone consults have been increased to $205 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 1, 2010 Report Share Posted August 1, 2010 Oops! Sent this too soon..I understand general cost increases. But please don't try to blame it on insurance when they don't take insurance ;-) Kristy Nardini TazziniTM Stainless Steel Bottles <http://www.tazzini.com/> http://www.tazzini.com kristy@... Phone: 858.243.1929 Fax: 858.724.1418 P Please consider the environment before printing this email. From: [mailto: ] On Behalf Of Kristy Nardini Sent: Sunday, August 01, 2010 7:20 AM Subject: RE: Telephone consult $ Dr. G doesn't take insurance!!! How can they feel the squeeze when they only take insurance from one company? Pass the costs on to those who use their insurance! Kristy Nardini TazziniTM Stainless Steel Bottles <http://www.tazzini.com/> http://www.tazzini.com kristy@... <mailto:kristy%40tazzini.com> Phone: 858.243.1929 Fax: 858.724.1418 P Please consider the environment before printing this email. From: <mailto:%40> [mailto: <mailto:%40> ] On Behalf Of Crosss Sent: Friday, July 30, 2010 3:21 PM <mailto:%40> Subject: RE: Telephone consult $ Yep - we just got the notice in our monthly statement $205. First increase since 2004. They are getting squeezed by insurance co's like all of us _____ From: <mailto:%40> <mailto:%40> [mailto: <mailto:%40> <mailto:%40> ] On Behalf Of Doris and Steve Sent: Friday, July 30, 2010 10:26 AM Subject: Telephone consult $ Just a heads up - telephone consults have been increased to $205 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 1, 2010 Report Share Posted August 1, 2010 Consider that Dr G needs to pay for liability, E & O and malpractice insurance he is getting squeezed. Insurance costs ate one of a doctors biggest expenses. Sent from my iPhone On Aug 1, 2010, at 10:19 AM, " Kristy Nardini " <knardini@...> wrote: Dr. G doesn't take insurance!!! How can they feel the squeeze when they only take insurance from one company? Pass the costs on to those who use their insurance! Kristy Nardini TazziniTM Stainless Steel Bottles <http://www.tazzini.com/> http://www.tazzini.com kristy@... Phone: 858.243.1929 Fax: 858.724.1418 P Please consider the environment before printing this email. From: [mailto: ] On Behalf Of Crosss Sent: Friday, July 30, 2010 3:21 PM Subject: RE: Telephone consult $ Yep - we just got the notice in our monthly statement $205. First increase since 2004. They are getting squeezed by insurance co's like all of us _____ From: <mailto:%40> [mailto: <mailto:%40> ] On Behalf Of Doris and Steve Sent: Friday, July 30, 2010 10:26 AM Subject: Telephone consult $ Just a heads up - telephone consults have been increased to $205 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 1, 2010 Report Share Posted August 1, 2010 They do take insurance - but not a large range. United Healthcare, PacifiCare and Blue Shield of CA but not Blue Cross. It was Dr G's office that cited the insurance cost issues to me when I asked about why the increase. Insurance companies are demanding bigger discounts for the Dr's to stay " in-network " , and demanding higher premiums and bigger co-pay's from customers. The other thing is that there was reported the other day, an overall decline in medical treatment across the country, therefore in theory reducing revenues. Yet United Healthcare reported a healthy increase in profit for the first half! R _____ From: [mailto: ] On Behalf Of Kristy Nardini Sent: Sunday, August 01, 2010 7:50 AM Subject: RE: Telephone consult $ Oops! Sent this too soon..I understand general cost increases. But please don't try to blame it on insurance when they don't take insurance ;-) Kristy Nardini TazziniTM Stainless Steel Bottles <http://www.tazzini.com/> http://www.tazzini.com kristy@... <mailto:kristy%40tazzini.com> Phone: 858.243.1929 Fax: 858.724.1418 P Please consider the environment before printing this email. From: <mailto:%40> [mailto: <mailto:%40> ] On Behalf Of Kristy Nardini Sent: Sunday, August 01, 2010 7:20 AM <mailto:%40> Subject: RE: Telephone consult $ Dr. G doesn't take insurance!!! How can they feel the squeeze when they only take insurance from one company? Pass the costs on to those who use their insurance! Kristy Nardini TazziniTM Stainless Steel Bottles <http://www.tazzini.com/> http://www.tazzini.com kristy@... <mailto:kristy%40tazzini.com> <mailto:kristy%40tazzini.com> Phone: 858.243.1929 Fax: 858.724.1418 P Please consider the environment before printing this email. From: <mailto:%40> <mailto:%40> [mailto: <mailto:%40> <mailto:%40> ] On Behalf Of Crosss Sent: Friday, July 30, 2010 3:21 PM <mailto:%40> <mailto:%40> Subject: RE: Telephone consult $ Yep - we just got the notice in our monthly statement $205. First increase since 2004. They are getting squeezed by insurance co's like all of us _____ From: <mailto:%40> <mailto:%40> <mailto:%40> [mailto: <mailto:%40> <mailto:%40> <mailto:%40> ] On Behalf Of Doris and Steve Sent: Friday, July 30, 2010 10:26 AM Subject: Telephone consult $ Just a heads up - telephone consults have been increased to $205 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 2, 2010 Report Share Posted August 2, 2010 We get them partially covered. We need to submit the bills ourselves with a claim form. Check with your insurance rep to see what can be covered.  Best,  From: <cmarnett2@...> Subject: Re: Telephone consult $ Date: Saturday, July 31, 2010, 1:47 PM  Hi Do you get the telephone consults covered by your insurance? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 2, 2010 Report Share Posted August 2, 2010 I get so frustrated that 1) my insurance premiums keep going up and 2) my medical costs keep going up and 3) my insurance covers LESS and LESS of my medical costs! When does this madness end??? It's the insult to the injury of having an unhealthy family to begin with. Kristy Nardini TazziniTM Stainless Steel Bottles <http://www.tazzini.com/> http://www.tazzini.com kristy@... Phone: 858.243.1929 Fax: 858.724.1418 P Please consider the environment before printing this email. From: [mailto: ] On Behalf Of Crosss Sent: Sunday, August 01, 2010 12:36 PM Subject: RE: Telephone consult $ They do take insurance - but not a large range. United Healthcare, PacifiCare and Blue Shield of CA but not Blue Cross. It was Dr G's office that cited the insurance cost issues to me when I asked about why the increase. Insurance companies are demanding bigger discounts for the Dr's to stay " in-network " , and demanding higher premiums and bigger co-pay's from customers. The other thing is that there was reported the other day, an overall decline in medical treatment across the country, therefore in theory reducing revenues. Yet United Healthcare reported a healthy increase in profit for the first half! R _____ From: <mailto:%40> [mailto: <mailto:%40> ] On Behalf Of Kristy Nardini Sent: Sunday, August 01, 2010 7:50 AM <mailto:%40> Subject: RE: Telephone consult $ Oops! Sent this too soon..I understand general cost increases. But please don't try to blame it on insurance when they don't take insurance ;-) Kristy Nardini TazziniTM Stainless Steel Bottles <http://www.tazzini.com/> http://www.tazzini.com kristy@... <mailto:kristy%40tazzini.com> <mailto:kristy%40tazzini.com> Phone: 858.243.1929 Fax: 858.724.1418 P Please consider the environment before printing this email. From: <mailto:%40> <mailto:%40> [mailto: <mailto:%40> <mailto:%40> ] On Behalf Of Kristy Nardini Sent: Sunday, August 01, 2010 7:20 AM <mailto:%40> <mailto:%40> Subject: RE: Telephone consult $ Dr. G doesn't take insurance!!! How can they feel the squeeze when they only take insurance from one company? Pass the costs on to those who use their insurance! Kristy Nardini TazziniTM Stainless Steel Bottles <http://www.tazzini.com/> http://www.tazzini.com kristy@... <mailto:kristy%40tazzini.com> <mailto:kristy%40tazzini.com> <mailto:kristy%40tazzini.com> Phone: 858.243.1929 Fax: 858.724.1418 P Please consider the environment before printing this email. From: <mailto:%40> <mailto:%40> <mailto:%40> [mailto: <mailto:%40> <mailto:%40> <mailto:%40> ] On Behalf Of Crosss Sent: Friday, July 30, 2010 3:21 PM <mailto:%40> <mailto:%40> <mailto:%40> Subject: RE: Telephone consult $ Yep - we just got the notice in our monthly statement $205. First increase since 2004. They are getting squeezed by insurance co's like all of us _____ From: <mailto:%40> <mailto:%40> <mailto:%40> <mailto:%40> [mailto: <mailto:%40> <mailto:%40> <mailto:%40> <mailto:%40> ] On Behalf Of Doris and Steve Sent: Friday, July 30, 2010 10:26 AM Subject: Telephone consult $ Just a heads up - telephone consults have been increased to $205 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2010 Report Share Posted August 4, 2010 Persistence mainly. Make sure that you submit the right codes. Autism is generally not covered by insurers, so it needs to be coded as a viral infection. The reason that autism is not covered is because insurers view it as a non-treatable condition, but a viral infection is of course treatable.  Best,  From: <cmarnett2@...> Subject: Re: Telephone consult $ Date: Saturday, July 31, 2010, 1:47 PM  Hi Do you get the telephone consults covered by your insurance? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2010 Report Share Posted August 4, 2010 Wow! That's great! How did you convince them to do that?? > > > From: <cmarnett2@...> > Subject: Re: Telephone consult $ > > Date: Saturday, July 31, 2010, 1:47 PM > > > Â > > > > Hi > > Do you get the telephone consults covered by your insurance? > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 It's pretty unusual to get coverage for phone consults w/most insurance companies, unless you can prove that a specialist is needed who isn't available locally. And since & immune dysfunction is not currently accepted in mainstream medicine, it can be very difficult to convince your insurance company to approve them. Usually the only ones I've seen cover them are smaller groups like individual Aetna policies, maybe Principal... and it probably depends on how the contracts are written, too. If the company can see the potential for cost savings thru Dr Goldberg (like a child's constant doctor visits and tests being reduced after being under his care, for instance), then they may consider coverage. But again, it's hard. Add to the fact that labs frequently don't support infection (because the dysfunction doesn't show up, and symptoms of chronic infection aren't so evident in our kids), and insurance is perfectly within their rights to deny coverage for it. But it doesn't hurt to request it if you have something significant you can show for improvement, especially when blood work makes improvements, or you have very high viral titers, etc. (Even then, it's hard, because you should ideally be able to see someone local in the mainstream view.) ________________________________ From: dabowookie <dabowookie@...> Sent: Wed, August 4, 2010 8:15:22 PM Subject: Re: Telephone consult $  Wow! That's great! How did you convince them to do that?? > > > From: <cmarnett2@...> > Subject: Re: Telephone consult $ > > Date: Saturday, July 31, 2010, 1:47 PM > > >  > > > > Hi > > Do you get the telephone consults covered by your insurance? > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 I strongly disagree. Immune dysfunction diagnosis is the key. There are literally no docs treating this in children and if you press you can get coverage. The fact that there are no docs out there is the argument that needs to be put forth. The trick is to get your gen practice pediatrician to prescribe/recommend a specialist. If the insurance company argues tell them to find a pediatric immunologist in your area " on the plan " . Will not happen, period, ever! The Autism diagnosis is the stopper. Insurance companies embrace the doomsday diagnosis, nothing well help, so no coverage. Stand your ground based on the corrected diagnosis of a dysfunctional immune system based on the lab results and demand a specialist!. Then request Dr G or Dr Russel as the only resort! ________________________________ From: <thecolemans4@...> Sent: Fri, August 6, 2010 9:42:32 PM Subject: Re: Re: Telephone consult $ It's pretty unusual to get coverage for phone consults w/most insurance companies, unless you can prove that a specialist is needed who isn't available locally. And since & immune dysfunction is not currently accepted in mainstream medicine, it can be very difficult to convince your insurance company to approve them. Usually the only ones I've seen cover them are smaller groups like individual Aetna policies, maybe Principal... and it probably depends on how the contracts are written, too. If the company can see the potential for cost savings thru Dr Goldberg (like a child's constant doctor visits and tests being reduced after being under his care, for instance), then they may consider coverage. But again, it's hard. Add to the fact that labs frequently don't support infection (because the dysfunction doesn't show up, and symptoms of chronic infection aren't so evident in our kids), and insurance is perfectly within their rights to deny coverage for it. But it doesn't hurt to request it if you have something significant you can show for improvement, especially when blood work makes improvements, or you have very high viral titers, etc. (Even then, it's hard, because you should ideally be able to see someone local in the mainstream view.) ________________________________ From: dabowookie <dabowookie@...> Sent: Wed, August 4, 2010 8:15:22 PM Subject: Re: Telephone consult $ Wow! That's great! How did you convince them to do that?? > > > From: <cmarnett2@...> > Subject: Re: Telephone consult $ > > Date: Saturday, July 31, 2010, 1:47 PM > > > Â > > > > Hi > > Do you get the telephone consults covered by your insurance? > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2010 Report Share Posted August 7, 2010 I like how you think, Bill. But I have Blue Cross Blue Sheild PPO and they gave me blanket statement that phone consults are not covered. Unfortunately when I had my daughter's bloodwork done, it didn't look too disturbing. But she has greatly benefitted from our working with Dr. and cooling down her immune system. I am afraid that they (the general doctor and insurance) would slough me off and say this is medically unnecessary, though. If you have some tips or personal experience with this please share. I am broke and could certainly use some help from insurance! - > > > > > > From: <cmarnett2@> > > Subject: Re: Telephone consult $ > > > > Date: Saturday, July 31, 2010, 1:47 PM > > > > > > Â > > > > > > > > Hi > > > > Do you get the telephone consults covered by your insurance? > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2010 Report Share Posted August 7, 2010 Dear , My son 's lab work didn't show any odvious signs of immune system dysfunction until we started the antiviral treatment. Then they looked scary until he started healing. Regards, 's Story - Stop Calling It Autism! http://www.stopcallingitautism.net > > > > > > > > > From: <cmarnett2@> > > > Subject: Re: Telephone consult $ > > > > > > Date: Saturday, July 31, 2010, 1:47 PM > > > > > > > > > Â > > > > > > > > > > > > Hi > > > > > > Do you get the telephone consults covered by your insurance? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2010 Report Share Posted August 7, 2010 I had the same experience. We have Blue Shield POS (PPO and HMO), and was also clearly told that this is not a covered service. I would be interested in knowing if there are other ways that this service can be billed.  Thanks for any suggestion  Karla From: <jlhank80@...> Subject: Re: Telephone consult $ Date: Friday, August 6, 2010, 11:08 PM  I like how you think, Bill. But I have Blue Cross Blue Sheild PPO and they gave me blanket statement that phone consults are not covered. Unfortunately when I had my daughter's bloodwork done, it didn't look too disturbing. But she has greatly benefitted from our working with Dr. and cooling down her immune system. I am afraid that they (the general doctor and insurance) would slough me off and say this is medically unnecessary, though. If you have some tips or personal experience with this please share. I am broke and could certainly use some help from insurance! - > > > > > > From: <cmarnett2@> > > Subject: Re: Telephone consult $ > > > > Date: Saturday, July 31, 2010, 1:47 PM > > > > > > Â > > > > > > > > Hi > > > > Do you get the telephone consults covered by your insurance? > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 7, 2010 Report Share Posted August 7, 2010 Hey Karla, No, there's not another CPT code that can be used. The PPO plans and HMOs typically won't cover the phone consults. However, you can ask if your policy has a case manager option, and on occasion, you can have someone who can approve services that would otherwise not be covered. BUT you run the risk of them looking over the medical history and saying that there's no medical indication for the need for antifungals or antivirals and they could stop covering it, which would cost a lot more than the phone consults. Sorry... ________________________________ From: Karla Fine <karla_fine@...> Sent: Sat, August 7, 2010 10:55:59 AM Subject: Re: Re: Telephone consult $  I had the same experience. We have Blue Shield POS (PPO and HMO), and was also clearly told that this is not a covered service. I would be interested in knowing if there are other ways that this service can be billed.  Thanks for any suggestion  Karla From: <jlhank80@...> Subject: Re: Telephone consult $ Date: Friday, August 6, 2010, 11:08 PM  I like how you think, Bill. But I have Blue Cross Blue Sheild PPO and they gave me blanket statement that phone consults are not covered. Unfortunately when I had my daughter's bloodwork done, it didn't look too disturbing. But she has greatly benefitted from our working with Dr. and cooling down her immune system. I am afraid that they (the general doctor and insurance) would slough me off and say this is medically unnecessary, though. If you have some tips or personal experience with this please share. I am broke and could certainly use some help from insurance! - > > > > > > From: <cmarnett2@> > > Subject: Re: Telephone consult $ > > > > Date: Saturday, July 31, 2010, 1:47 PM > > > > > > Â > > > > > > > > Hi > > > > Do you get the telephone consults covered by your insurance? > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2010 Report Share Posted August 8, 2010 I see... Thank you ! From: <jlhank80@...> Subject: Re: Telephone consult $ Date: Friday, August 6, 2010, 11:08 PM  I like how you think, Bill. But I have Blue Cross Blue Sheild PPO and they gave me blanket statement that phone consults are not covered. Unfortunately when I had my daughter's bloodwork done, it didn't look too disturbing. But she has greatly benefitted from our working with Dr. and cooling down her immune system. I am afraid that they (the general doctor and insurance) would slough me off and say this is medically unnecessary, though. If you have some tips or personal experience with this please share. I am broke and could certainly use some help from insurance! - > > > > > > From: <cmarnett2@> > > Subject: Re: Telephone consult $ > > > > Date: Saturday, July 31, 2010, 1:47 PM > > > > > > Â > > > > > > > > Hi > > > > Do you get the telephone consults covered by your insurance? > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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