Fw: Problem with Provider, St. Francis pg 1

[Guest guest]

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. "