Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 Randy, So how do I go about finding out if my insurance will cover a second one? Do I have to have my doctor fill out forms again to see? Or should I just call my insurance to see if I talk to someone who might know if they will or not. I swear I can call different times and get different answers. Deb A Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 Randy, So how do I go about finding out if my insurance will cover a second one? Do I have to have my doctor fill out forms again to see? Or should I just call my insurance to see if I talk to someone who might know if they will or not. I swear I can call different times and get different answers. Deb A Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 Hi Deb, The size of the Vest is based on chest circumference. The Full Vest (black) is as follows: Child Medium 23 - 27 inches Child Large >27 - 31 inches Adult Small >31 - 36 inches Adult Medium >36 - 45 inches Adult Large >45 - 52 inches The Chest Vest (blue) is as follows: No children sizes Adult Small 28 - 35 inches (can also be used with an older child) Adult Medium >35 - 46 inches Adult Large >46 - 61 inches Adult X-Large >61 - 67 inches If you need to move up, just call Customer Service at 1- and let them know. There is no additional cost. Getting the next size Vest is part of our service to you. Insurances are very reluctant to pay for a second device unless there is overwhelming medical evidence that a second device is necessary. Any time they think that it is for convenience, they deny it immediately. Most of the approvals for second devices are from families who have one child leaving the home (i.e. college, moving out, etc.). Other than that, the insurances are pretty tough when it comes to a second device. Some insurances will pay for a short-term rental, but, again, there has to be significant evidence that not using the Vest will have detrimental effects on the patient. As far as having a smaller device, there is not one on the market as of yet. The Model 103 is our most current device. I hope this helps, Deb. Please let me know if there is anything else I can do. Randy Vest Question Randy, Right now I have the child's medium and child's large vest. I was wondering at what age should we think about getting another vest. is 10 and at age 6 she was using the large one and my youngest was using the medium. My youngest will also will be 6 so I was wondering if you think we should be thinking about new ones. Also next year my oldest for school has the opportunity to go to camp with her class. They stay for 3 night. I was wondering if our insurance would pay for a second vest? I heard they have a smaller vest for traveling. Do you think we could get one like that? Deb A ------------------------------------------- The opinions and information exchanged on this list should IN NO WAY be construed as medical advice. PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY MEDICATIONS OR TREATMENTS. ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 Hi Deb, The size of the Vest is based on chest circumference. The Full Vest (black) is as follows: Child Medium 23 - 27 inches Child Large >27 - 31 inches Adult Small >31 - 36 inches Adult Medium >36 - 45 inches Adult Large >45 - 52 inches The Chest Vest (blue) is as follows: No children sizes Adult Small 28 - 35 inches (can also be used with an older child) Adult Medium >35 - 46 inches Adult Large >46 - 61 inches Adult X-Large >61 - 67 inches If you need to move up, just call Customer Service at 1- and let them know. There is no additional cost. Getting the next size Vest is part of our service to you. Insurances are very reluctant to pay for a second device unless there is overwhelming medical evidence that a second device is necessary. Any time they think that it is for convenience, they deny it immediately. Most of the approvals for second devices are from families who have one child leaving the home (i.e. college, moving out, etc.). Other than that, the insurances are pretty tough when it comes to a second device. Some insurances will pay for a short-term rental, but, again, there has to be significant evidence that not using the Vest will have detrimental effects on the patient. As far as having a smaller device, there is not one on the market as of yet. The Model 103 is our most current device. I hope this helps, Deb. Please let me know if there is anything else I can do. Randy Vest Question Randy, Right now I have the child's medium and child's large vest. I was wondering at what age should we think about getting another vest. is 10 and at age 6 she was using the large one and my youngest was using the medium. My youngest will also will be 6 so I was wondering if you think we should be thinking about new ones. Also next year my oldest for school has the opportunity to go to camp with her class. They stay for 3 night. I was wondering if our insurance would pay for a second vest? I heard they have a smaller vest for traveling. Do you think we could get one like that? Deb A ------------------------------------------- The opinions and information exchanged on this list should IN NO WAY be construed as medical advice. PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY MEDICATIONS OR TREATMENTS. ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 Hi Deb, The size of the Vest is based on chest circumference. The Full Vest (black) is as follows: Child Medium 23 - 27 inches Child Large >27 - 31 inches Adult Small >31 - 36 inches Adult Medium >36 - 45 inches Adult Large >45 - 52 inches The Chest Vest (blue) is as follows: No children sizes Adult Small 28 - 35 inches (can also be used with an older child) Adult Medium >35 - 46 inches Adult Large >46 - 61 inches Adult X-Large >61 - 67 inches If you need to move up, just call Customer Service at 1- and let them know. There is no additional cost. Getting the next size Vest is part of our service to you. Insurances are very reluctant to pay for a second device unless there is overwhelming medical evidence that a second device is necessary. Any time they think that it is for convenience, they deny it immediately. Most of the approvals for second devices are from families who have one child leaving the home (i.e. college, moving out, etc.). Other than that, the insurances are pretty tough when it comes to a second device. Some insurances will pay for a short-term rental, but, again, there has to be significant evidence that not using the Vest will have detrimental effects on the patient. As far as having a smaller device, there is not one on the market as of yet. The Model 103 is our most current device. I hope this helps, Deb. Please let me know if there is anything else I can do. Randy Vest Question Randy, Right now I have the child's medium and child's large vest. I was wondering at what age should we think about getting another vest. is 10 and at age 6 she was using the large one and my youngest was using the medium. My youngest will also will be 6 so I was wondering if you think we should be thinking about new ones. Also next year my oldest for school has the opportunity to go to camp with her class. They stay for 3 night. I was wondering if our insurance would pay for a second vest? I heard they have a smaller vest for traveling. Do you think we could get one like that? Deb A ------------------------------------------- The opinions and information exchanged on this list should IN NO WAY be construed as medical advice. PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY MEDICATIONS OR TREATMENTS. ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 I know, Deb. It is very frustrating. I know that many patients with CF are assigned a case manager by the insurance company. The CM monitors what is being done and what is being used to insure that the insurance dollars are spent efficiently and that the patient gets what they need. If you have a CM, that would be your starting point. Call your insurance and ask them if a CM or a catastrophic CM has been assigned to your case. If not, then ask for senior benefits analyst (in other words, the people answering the phone may not know the answer and tell you things that are wrong). Tell them your situation and ask them what is covered. Remember, if they hear you say something about " convenience " , game over. You can also talk to your MD and see if they will call the insurance. Sometimes they will, depending on your relationship with your MD. Remember to document everything...names, times called, numbers, dates, etc. It will be crucial for you to do this. We have tried to submit scripts for second devices and have had very poor results. If it comes from us, they tend to put up huge roadblocks and walls. We have seen better results if the patient/family and/or the physician initiate the contact. I know this is not much help, Deb. I hope it answers some of your questions. Let me know if there is anything else I can do. Randy Re: Vest Question Randy, So how do I go about finding out if my insurance will cover a second one? Do I have to have my doctor fill out forms again to see? Or should I just call my insurance to see if I talk to someone who might know if they will or not. I swear I can call different times and get different answers. Deb A ______________________________________________________________ Information contained in this e-mail message may be legally privileged and confidential information intended only for the use of the individual(s) named above. If the reader of this message is not the intended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this e-mail is strictly prohibited. If e-mailed messages include MEDICAL RECORDS, these records ARE PRIVILEGED AND CONFIDENTIAL and may be released only upon written permission of the patient. If you have received this e-mail in error, please immediately notify the sender by telephone at 1- and delete this e-mail. Thank you! ______________________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 I know, Deb. It is very frustrating. I know that many patients with CF are assigned a case manager by the insurance company. The CM monitors what is being done and what is being used to insure that the insurance dollars are spent efficiently and that the patient gets what they need. If you have a CM, that would be your starting point. Call your insurance and ask them if a CM or a catastrophic CM has been assigned to your case. If not, then ask for senior benefits analyst (in other words, the people answering the phone may not know the answer and tell you things that are wrong). Tell them your situation and ask them what is covered. Remember, if they hear you say something about " convenience " , game over. You can also talk to your MD and see if they will call the insurance. Sometimes they will, depending on your relationship with your MD. Remember to document everything...names, times called, numbers, dates, etc. It will be crucial for you to do this. We have tried to submit scripts for second devices and have had very poor results. If it comes from us, they tend to put up huge roadblocks and walls. We have seen better results if the patient/family and/or the physician initiate the contact. I know this is not much help, Deb. I hope it answers some of your questions. Let me know if there is anything else I can do. Randy Re: Vest Question Randy, So how do I go about finding out if my insurance will cover a second one? Do I have to have my doctor fill out forms again to see? Or should I just call my insurance to see if I talk to someone who might know if they will or not. I swear I can call different times and get different answers. Deb A ______________________________________________________________ Information contained in this e-mail message may be legally privileged and confidential information intended only for the use of the individual(s) named above. If the reader of this message is not the intended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this e-mail is strictly prohibited. If e-mailed messages include MEDICAL RECORDS, these records ARE PRIVILEGED AND CONFIDENTIAL and may be released only upon written permission of the patient. If you have received this e-mail in error, please immediately notify the sender by telephone at 1- and delete this e-mail. Thank you! ______________________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 I know, Deb. It is very frustrating. I know that many patients with CF are assigned a case manager by the insurance company. The CM monitors what is being done and what is being used to insure that the insurance dollars are spent efficiently and that the patient gets what they need. If you have a CM, that would be your starting point. Call your insurance and ask them if a CM or a catastrophic CM has been assigned to your case. If not, then ask for senior benefits analyst (in other words, the people answering the phone may not know the answer and tell you things that are wrong). Tell them your situation and ask them what is covered. Remember, if they hear you say something about " convenience " , game over. You can also talk to your MD and see if they will call the insurance. Sometimes they will, depending on your relationship with your MD. Remember to document everything...names, times called, numbers, dates, etc. It will be crucial for you to do this. We have tried to submit scripts for second devices and have had very poor results. If it comes from us, they tend to put up huge roadblocks and walls. We have seen better results if the patient/family and/or the physician initiate the contact. I know this is not much help, Deb. I hope it answers some of your questions. Let me know if there is anything else I can do. Randy Re: Vest Question Randy, So how do I go about finding out if my insurance will cover a second one? Do I have to have my doctor fill out forms again to see? Or should I just call my insurance to see if I talk to someone who might know if they will or not. I swear I can call different times and get different answers. Deb A ______________________________________________________________ Information contained in this e-mail message may be legally privileged and confidential information intended only for the use of the individual(s) named above. If the reader of this message is not the intended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this e-mail is strictly prohibited. If e-mailed messages include MEDICAL RECORDS, these records ARE PRIVILEGED AND CONFIDENTIAL and may be released only upon written permission of the patient. If you have received this e-mail in error, please immediately notify the sender by telephone at 1- and delete this e-mail. Thank you! ______________________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 In a message dated 12/16/2002 1:58:29 PM Central Standard Time, rgarcia@... writes: > I know, Deb. It is very frustrating. I know that many patients with CF are > assigned a case manager by the insurance company. The CM monitors what is > being done and what is being used to insure that the insurance dollars are > spent efficiently and that the patient gets what they need. If you have a > CM, that would be your starting point. Call your insurance and ask them if > a CM or a catastrophic CM has been assigned to your case. > > If not, then ask for senior benefits analyst (in other words, the people > answering the phone may not know the answer and tell you things that are > wrong). Tell them your situation and ask them what is covered. Remember, > if they hear you say something about " convenience " , game over. > > You can also talk to your MD and see if they will call the insurance. > Sometimes they will, depending on your relationship with your MD. > > Remember to document everything...names, times called, numbers, dates, etc. > It will be crucial for you to do this. > > We have tried to submit scripts for second devices and have had very poor > results. If it comes from us, they tend to put up huge roadblocks and > walls. We have seen better results if the patient/family and/or the > physician initiate the contact. > > I know this is not much help, Deb. I hope it answers some of your > questions. Let me know if there is anything else I can do. > > Randy Thanks Randy it's a start and it can't hurt to try. Thanks for all of you help! Deb A Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 How do I get my name removed from list. Don't have alot of time to read e-mails. Thanks Tresa Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 How do I get my name removed from list. Don't have alot of time to read e-mails. Thanks Tresa Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2002 Report Share Posted December 16, 2002 How do I get my name removed from list. Don't have alot of time to read e-mails. Thanks Tresa Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 18, 2002 Report Share Posted December 18, 2002 Hi Tresa, sorry for being late with this. I have changed your subscription to Special Notices now. Only a few messages a month and you can still post to the list if you like. Have a Merry Christmas! Peace Torsten, dad of Fiona 5wcf e-mail: torstenkrafft@... Re: Vest Question > How do I get my name removed from list. Don't have alot of time to read > e-mails. > Thanks > Tresa > > > ------------------------------------------- > The opinions and information exchanged on this list should IN NO WAY > be construed as medical advice. > > PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY MEDICATIONS OR TREATMENTS. > > ------------------------------------ > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 18, 2002 Report Share Posted December 18, 2002 Hi Tresa, sorry for being late with this. I have changed your subscription to Special Notices now. Only a few messages a month and you can still post to the list if you like. Have a Merry Christmas! Peace Torsten, dad of Fiona 5wcf e-mail: torstenkrafft@... Re: Vest Question > How do I get my name removed from list. Don't have alot of time to read > e-mails. > Thanks > Tresa > > > ------------------------------------------- > The opinions and information exchanged on this list should IN NO WAY > be construed as medical advice. > > PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY MEDICATIONS OR TREATMENTS. > > ------------------------------------ > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 23, 2002 Report Share Posted December 23, 2002 on 12/18/02 1:17 PM, Torsten Krafft at Torstenkrafft@... wrote: > Hi Tresa, > > sorry for being late with this. I have changed your subscription to Special > Notices now. Only a few messages a month and you can still post to the list > if you like. > > Have a Merry Christmas! > > Peace > Torsten, dad of Fiona 5wcf > e-mail: torstenkrafft@... > Re: Vest Question > > >> How do I get my name removed from list. Don't have alot of time to read >> e-mails. >> Thanks >> Tresa >> >> >> ------------------------------------------- >> The opinions and information exchanged on this list should IN NO WAY >> be construed as medical advice. >> >> PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY MEDICATIONS OR > TREATMENTS. >> >> ------------------------------------ >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 23, 2002 Report Share Posted December 23, 2002 on 12/18/02 1:17 PM, Torsten Krafft at Torstenkrafft@... wrote: > Hi Tresa, > > sorry for being late with this. I have changed your subscription to Special > Notices now. Only a few messages a month and you can still post to the list > if you like. > > Have a Merry Christmas! > > Peace > Torsten, dad of Fiona 5wcf > e-mail: torstenkrafft@... > Re: Vest Question > > >> How do I get my name removed from list. Don't have alot of time to read >> e-mails. >> Thanks >> Tresa >> >> >> ------------------------------------------- >> The opinions and information exchanged on this list should IN NO WAY >> be construed as medical advice. >> >> PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY MEDICATIONS OR > TREATMENTS. >> >> ------------------------------------ >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 23, 2002 Report Share Posted December 23, 2002 on 12/18/02 1:17 PM, Torsten Krafft at Torstenkrafft@... wrote: > Hi Tresa, > > sorry for being late with this. I have changed your subscription to Special > Notices now. Only a few messages a month and you can still post to the list > if you like. > > Have a Merry Christmas! > > Peace > Torsten, dad of Fiona 5wcf > e-mail: torstenkrafft@... > Re: Vest Question > > >> How do I get my name removed from list. Don't have alot of time to read >> e-mails. >> Thanks >> Tresa >> >> >> ------------------------------------------- >> The opinions and information exchanged on this list should IN NO WAY >> be construed as medical advice. >> >> PLEASE CONSULT YOUR PHYSICIAN BEFORE CHANGING ANY MEDICATIONS OR > TREATMENTS. >> >> ------------------------------------ >> >> >> Quote Link to comment Share on other sites More sharing options...
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