Re: It's not about lying, guys. Alan, Chris

[Guest guest]

Hey, just to clarify...I wasn't referring to JRI..in fact, I actually

said " kudos " to them FOR disclosing the device. I'm not out to bash

anyone, I was only expressing my personal deal/opinion, which I'm

sure many do not agree with. Other offices/docs are not disclosing

though, and you're absolutely right, it's a code thing - it's not so

much that they're not disclosing...more than they're just

using/submitting the " right " codes. So the point? Your case wasn't

what I was referring to - as the device was disclosed.

Sorry for any misunderstanding. I knew your deal, and don't judge

anyone else for goin' that route at all! 'Cuz let's face it, as you

said, it IS a hip repl...and some day it WILL be covered (it better

be!) ... and we all gotta do what we gotta do, no? )

In surfacehippy , " Roche " wrote:

> Alan,

> To be honest, the reason I was concerned enough to ask Chuck

> about the possible " deception " involved with he coding was to be

> sure that I didn't end up with the bill after they got " caught " . As

> well, I wouldn't be comfortable being a thief, even if it was a

> stinking insurance company that I was hornswaggling. And to be

sure,

> something transpired between the time I was resurfed (billed as a

> THR but with the device disclosed) and now, cuz they sure don't

want

> to bill it that way now. But I suppose I get defensive about it

when

> it seemed to be implied that either I or Dr. Amstutz office would

> knowingly lie or steal. Cuz it just didn't go down like that, and I

> doubt it ever did at JRI. It just doesn't add up that a mogul (sp?)

> like Dr. A would do something slimy like that, and I feel it may

> impune his good name to suggest as much. (not that you did, but

some

> have). It's als about the facts in here.

>

> C+ Amstutz 4-15-04

>

>

>

> > Chris...

> >

> > If that's truly the way it works, and the insurance company

> > understands the same thing the doc does, and if everybody is

> playing

> > the same shell game by the same (mutually understood rules) I

have

> no

> > problem. If the doc writes something that SEEMS to comply with

an

> > insurance company coding, but is actually something else...I

still

> > gotta say...that's not telling the truth. And if CIGNA is

> rejecting

> > these more than it's accepting them at JRI...but paying as much

as

> > 75% for a BHR Belgian resurf, I have to ask some serious

> questions.

> > (But, I must be honest: many people have said I'm too rigid about

> > such things.)

> >

> > Whatever my issues might be...you seem to to doing quite

> well...and

> > that makes you an exemplar of what's possible, however we pay for

> it.

> >

> > All the best,

> > Alan