Re: Fw: Problem with Provider, St. Francis pg 1

[Guest guest]

Hi Debbie.  After reading your story, I am flabbergasted that you were so

bombarded by St. Francis.  This is a gross injustice on people who are so sick

and need peacefulness, tranquility and no stress in their lives.  I admire all

the work you have been thru trying to solve this dilemma.  I am glad that you

have written it all down.  I would like your permission to go one better.  I am

currently putting a book together on how one with these diseases copes in their

daily life.  It is so difficult.  First it is almost impossible to find a doc

who believes in you.  Most people first think we are hypochondriacs.  Finally

when they realize, after much anguish, that we really are sick, we get hassled

from all ends and then the letters from collection agencies.  I have a similar

problem.  Cabrini hospital in NY closed down at the beginning of this year.  I

had some lab work done there.  I had both Medicare and medicaid, but the lazy

people in

the billing office did not bother billing the secondary (medicaid.)  So, six

months after they close, I get a letter from a collection agency for $37. and

some cents, threatening that they will ruin my credit rating if I don't pay this

bill.  I called them immediately.  Mind you, it was the first I had heard that I

owed them anything.  The woman got angry with me and said, " well it is only

$37.00.  I yelled back at her.  I told her, well maybe $37. is nothing to you,

but for me, on social security, and being 72 and unable to work, it is a weeks's

worth of groceries.  I haven't heard from the company again.  But if, I find out

that they have attached this to my credit rating, I will sue them, too.  Could I

put your story of frustration into my book.  I want people to know what we go

through fighting to remain alive and having these moronic people giving us so

much flack.  I, and a whole bunch of people might benefit from this.  I plan to

send a copy of the book to .  I think I'll also send the book to

Hillary and anyone else who will be working on the health care crisis.  But I do

need your permission to put your story with this hospital into the book. 

Waiting to hear from you. We do not need to use your name, if you don't want the

publicity.  There are some people who want to use ficticious names and that is

fine with me.   Hope getting this out will help us all.  Dolores & Mike

From: DEBBIE GIBSON <Debbullwinkle@...>

Subject: rheumatic Fw: Problem with Provider, St. Francis pg 1

" support group " <rheumatic >

Date: Monday, December 1, 2008, 8:40 PM

The following pages of posts details my ongoing battle with my provider for

Photopheresis. I would be grateful for any suggestions on how I can resolve this

situation... since I need photopheresis to breathe. This is page 1, I put the

entire letter in 4 emails...just in case our computer froze while typing. Thanks

everyone for reading, it is long, convoluted and a mess...as only dealing with

different agencies can be.

Problem with Provider, St. Francis

December 1, 2008

Congresswoman Schmidt

Attn: Long

8044 Montgomery Road, Suite 540

Cincinnati, Ohio 45236

Dear Honorable Congresswoman Schmidt:

I would appreciate it very much if you would help me with a problem I have been

having with my hospital provider, St. Francis. I receive a form of chemotherapy,

Photopheresis. I need this to breathe and have been receiving this every 6-7-8

weeks since August 2005 at St. Francis Hospital located in Beech Grove, Indiana.

I hand delivered a letter in February of 2008 to the St. Francis ADM. office

detailing many of these concerns and never received any response from the

hospital.

I am being penalized for having Medicare as primary insurance and would

appreciate your looking into how this hospital is handling my benefits. When

Anthem was my primary, there was no problem. Now that Medicare is my primary, I

am being penalized and balance billed by being forced to sign an ABN form even

though I have secondary insurance that has agreed to cover this treatment. (less

deductible and out of pocket) My deductible and out of pocket maximum with

Anthem is $5000 a year. The way St. Francis is trying to use this form, stating

that they would not balance bill, they only require it in order to bill Medicare

and then using it to balance bill the patient could result in charges of nearly

$ 7000 every time I receive treatment. Far over my out of pocket maximum and

deductible with Anthem.I have amended this form, with St. Francis's knowledge

and permission each time I have signed it. I sign this form with the disclaimer,

" I am NOT agreeing to pay

for medical charges other than deductible and out of pocket maximum left from

Anthem. " Channel 6, 's cameraman taped the interview with myself

and Pam Carlton, St. Francis billing office wherein Ms. Carlton repeatedly

assures me that the hospital would not be using the form to bill me, " my

signature is required because it is the only way the hospital can bill Medicare,

get the denial and then bill Anthem. " Further stating that even though " the form

states I may be asked to pay upfront, the hospital has no intention of doing

that either. "

[Guest guest]

Of course you may use the story in your book....using my name is fine as

well...It may help others deal with their providers...I think the hospital is

going to back down, I informed them today that I was coming for my treatment on

Mon/Tue and I was NOT signing anything at all...since they lied about why they

were having me sign it...and they said that was fine...I think they worried now

because several different entities are looking into what they have done. If we

could afford any atty, I would go after them...I am hoping once it makes the

papers, television, that an atty may offer to take it on a contingency and then

I will pursue it...

Let me know how else I can help. Debbie

Problem with Provider, St. Francis

December 1, 2008

Congresswoman Schmidt

Attn: Long

8044 Montgomery Road, Suite 540

Cincinnati, Ohio 45236

Dear Honorable Congresswoman Schmidt:

I would appreciate it very much if you would help me with a problem I have

been having with my hospital provider, St. Francis. I receive a form of

chemotherapy, Photopheresis. I need this to breathe and have been receiving this

every 6-7-8 weeks since August 2005 at St. Francis Hospital located in Beech

Grove, Indiana. I hand delivered a letter in February of 2008 to the St. Francis

ADM. office detailing many of these concerns and never received any response

from the hospital.

I am being penalized for having Medicare as primary insurance and would

appreciate your looking into how this hospital is handling my benefits. When

Anthem was my primary, there was no problem. Now that Medicare is my primary, I

am being penalized and balance billed by being forced to sign an ABN form even

though I have secondary insurance that has agreed to cover this treatment. (less

deductible and out of pocket) My deductible and out of pocket maximum with

Anthem is $5000 a year. The way St. Francis is trying to use this form, stating

that they would not balance bill, they only require it in order to bill Medicare

and then using it to balance bill the patient could result in charges of nearly

$ 7000 every time I receive treatment. Far over my out of pocket maximum and

deductible with Anthem.I have amended this form, with St. Francis's knowledge

and permission each time I have signed it. I sign this form with the disclaimer,

" I am NOT agreeing to pay

for medical charges other than deductible and out of pocket maximum left from

Anthem. " Channel 6, 's cameraman taped the interview with myself

and Pam Carlton, St. Francis billing office wherein Ms. Carlton repeatedly

assures me that the hospital would not be using the form to bill me, " my

signature is required because it is the only way the hospital can bill Medicare,

get the denial and then bill Anthem. " Further stating that even though " the form

states I may be asked to pay upfront, the hospital has no intention of doing

that either. "

[Guest guest]

Thank you Debbie.  This is going right into the book research file which I am

putting together.  My doc is behind me 100%.  She said we need a book on how

patients cope. I agree!  Take care, Dolores & Mike

From: DEBBIE GIBSON <Debbullwinkle@ fuse.net>

Subject: rheumatic Fw: Problem with Provider, St. Francis pg 1

" support group " <rheumatic@grou ps.com>

Date: Monday, December 1, 2008, 8:40 PM

The following pages of posts details my ongoing battle with my provider for

Photopheresis. I would be grateful for any suggestions on how I can resolve this

situation... since I need photopheresis to breathe. This is page 1, I put the

entire letter in 4 emails...just in case our computer froze while typing. Thanks

everyone for reading, it is long, convoluted and a mess...as only dealing with

different agencies can be.

Problem with Provider, St. Francis

December 1, 2008

Congresswoman Schmidt

Attn: Long

8044 Montgomery Road, Suite 540

Cincinnati, Ohio 45236

Dear Honorable Congresswoman Schmidt:

I would appreciate it very much if you would help me with a problem I have been

having with my hospital provider, St. Francis. I receive a form of chemotherapy,

Photopheresis. I need this to breathe and have been receiving this every 6-7-8

weeks since August 2005 at St. Francis Hospital located in Beech Grove, Indiana.

I hand delivered a letter in February of 2008 to the St. Francis ADM. office

detailing many of these concerns and never received any response from the

hospital.

I am being penalized for having Medicare as primary insurance and would

appreciate your looking into how this hospital is handling my benefits. When

Anthem was my primary, there was no problem. Now that Medicare is my primary, I

am being penalized and balance billed by being forced to sign an ABN form even

though I have secondary insurance that has agreed to cover this treatment. (less

deductible and out of pocket) My deductible and out of pocket maximum with

Anthem is $5000 a year. The way St. Francis is trying to use this form, stating

that they would not balance bill, they only require it in order to bill Medicare

and then using it to balance bill the patient could result in charges of nearly

$ 7000 every time I receive treatment. Far over my out of pocket maximum and

deductible with Anthem.I have amended this form, with St. Francis's knowledge

and permission each time I have signed it. I sign this form with the disclaimer,

" I am NOT agreeing to pay

for medical charges other than deductible and out of pocket maximum left from

Anthem. " Channel 6, 's cameraman taped the interview with myself

and Pam Carlton, St. Francis billing office wherein Ms. Carlton repeatedly

assures me that the hospital would not be using the form to bill me, " my

signature is required because it is the only way the hospital can bill Medicare,

get the denial and then bill Anthem. " Further stating that even though " the form

states I may be asked to pay upfront, the hospital has no intention of doing

that either. "