Insurance woes(long)

[Guest guest]

Hi all,

Sorry, I just need to vent. My husband is a teacher and a couple of years

ago, our insurance became so expensive that we were forced to drop it. At

that point, I was also very disillusioned by the medical establishment

anyway, so I just quit taking my son to neurologist, developmental ped., et

al. Finally, this year, we moved and my husband took a job with a bigger

school district with cheaper insurance. So we signed up. I asked them about

autism being a pre-existing condition, and was told that as long as I did not

take my son to any doctor for his autism for the 3 months prior to signing

up, it would be covered. Then, in December, I took him back to a neurologist

($300 visit). One month later, I received a letter from my insurance company

wanting a list of all doctors seen during the months between 6/01/00 to

9/01/00. So I did that. One doc was for my son's allergies(waited 3 months

for that appt., so I wasn't about to cancel.), one was for an eye infection,

and one was for a possible urinary tract infection. The doc I saw for the

UTI was in a clinic. It was an emergency. Anyway, I just received a letter

informing me that my claim at the neurologist has been denied as a

pre-existing condition. When I called about it, I was told that they denied

it based on the fact that they never heard back from the doc at the clinic.

Mind you, I sent addresses for these docs as well as phone numbers. They

sent one letter. I called that doctor and he claimed he never received a

letter. Anyway, he assured me that he would send the info right away. The

insurance company said that after they received that info, they would review

the claim. What really P.O.'s me is that they would send a letter--to me and

to neurologist--saying that the claim has been totally denied when they

haven't received all of the info. I hope I don't offend anyone here but I

HATE INSURANCE COMPANIES!!!!!! I'm sure they were hoping I would just pay the

bill myself and drop the claim. I wonder how many people would have done

that. Then they can deny all his autism claims for an entire year. Sorry to

vent.

[Guest guest]

I am an insurance agent which dealt with everthing but life and health and I

also hate insurance companies. If you keep quiet they won't ever pay, if you

fight with your voice, letters and have a doctor or government official

intervene they will pay. Keep up the hard work and your efforts will pay off.

I fought our HMO to the highest level about a claim and the day of the

hearing, they paid the claim. Of course after we drove over an hour to get

there they stated we changed our mind. Patience and persistence is the key

to success.

LOL,

Sharon

[Guest guest]

Yes

They do suck and i think they were hoping you would just pay for it

yourself. Veyr maddening. We are currently disputing claims as well. I

think they are hoping you will avoid the hassle. Fight like hell is what we

have to ---but once again , one more damn battle to fight. I understand. I

want my husband to change jobs but I do wonder if we will have insurance

issues after that--trouble getting PPO coverage. Take care and keep at it,

Insurance woes(long)

> Hi all,

> Sorry, I just need to vent. My husband is a teacher and a couple of years

> ago, our insurance became so expensive that we were forced to drop it. At

> that point, I was also very disillusioned by the medical establishment

> anyway, so I just quit taking my son to neurologist, developmental ped.,

et

> al. Finally, this year, we moved and my husband took a job with a bigger

> school district with cheaper insurance. So we signed up. I asked them

about

> autism being a pre-existing condition, and was told that as long as I did

not

> take my son to any doctor for his autism for the 3 months prior to signing

> up, it would be covered. Then, in December, I took him back to a

neurologist

> ($300 visit). One month later, I received a letter from my insurance

company

> wanting a list of all doctors seen during the months between 6/01/00 to

> 9/01/00. So I did that. One doc was for my son's allergies(waited 3

months

> for that appt., so I wasn't about to cancel.), one was for an eye

infection,

> and one was for a possible urinary tract infection. The doc I saw for the

> UTI was in a clinic. It was an emergency. Anyway, I just received a

letter

> informing me that my claim at the neurologist has been denied as a

> pre-existing condition. When I called about it, I was told that they

denied

> it based on the fact that they never heard back from the doc at the

clinic.

> Mind you, I sent addresses for these docs as well as phone numbers. They

> sent one letter. I called that doctor and he claimed he never received a

> letter. Anyway, he assured me that he would send the info right away.

The

> insurance company said that after they received that info, they would

review

> the claim. What really P.O.'s me is that they would send a letter--to me

and

> to neurologist--saying that the claim has been totally denied when they

> haven't received all of the info. I hope I don't offend anyone here but I

> HATE INSURANCE COMPANIES!!!!!! I'm sure they were hoping I would just pay

the

> bill myself and drop the claim. I wonder how many people would have done

> that. Then they can deny all his autism claims for an entire year. Sorry

to

> vent.

>

>

>

>