Re: Help w/ Scheduling Iowa appt.

[Guest guest]

Hi Michele, I don't know if this will help you or not but anyways..

When I took to see Dr.Ponseti in December I needed to find

out if they would accept my state(TX) Medicaid in Iowa so when I

called they referred me to the " Billings Dept. " I talked to a guy by

the name of Mark Mason. His # (319)384-5668. He was very nice and

helped me alot with all my billing questions. Hopefully he still

works there and you can speak with him. I only asked for him b/c my

daughter's ped had his nurse call and she spoke with another girl

and she told me she was really rude and unhelpful. I gave her to

speak with Mark and he helped us out. I hope he can help you too!

and

BL CF 12/16/03

> I called University of Iowa, the women there gave me a business

office

> number and said for me to call there, I called there and she said

they

> couldn't tell me if they accept our insurance or not to call the

> insurance company. I called the insurance company and they said I

> have to call the hospital and ask them. Is their an easier way to

> find out?? I'm just getting run around in circles. Does anyone

know

> how they started the process to go out there, that would kindly

> share. I fiugured first I should find out if they accept

insurance or

> not, then make an appoinment, then call my sons primary and get

the

> refferal. Please help!!!!

>

> Michele

[Guest guest]

Hi Michele, I don't know if this will help you or not but anyways..

When I took to see Dr.Ponseti in December I needed to find

out if they would accept my state(TX) Medicaid in Iowa so when I

called they referred me to the " Billings Dept. " I talked to a guy by

the name of Mark Mason. His # (319)384-5668. He was very nice and

helped me alot with all my billing questions. Hopefully he still

works there and you can speak with him. I only asked for him b/c my

daughter's ped had his nurse call and she spoke with another girl

and she told me she was really rude and unhelpful. I gave her to

speak with Mark and he helped us out. I hope he can help you too!

and

BL CF 12/16/03

> I called University of Iowa, the women there gave me a business

office

> number and said for me to call there, I called there and she said

they

> couldn't tell me if they accept our insurance or not to call the

> insurance company. I called the insurance company and they said I

> have to call the hospital and ask them. Is their an easier way to

> find out?? I'm just getting run around in circles. Does anyone

know

> how they started the process to go out there, that would kindly

> share. I fiugured first I should find out if they accept

insurance or

> not, then make an appoinment, then call my sons primary and get

the

> refferal. Please help!!!!

>

> Michele

[Guest guest]

Thanks ! I called and spoke with Mark, he was very nice. He

already called and checked and called me back. He says that it would

be out of network for my Insurance (Aetna) that we have a $1000

deductible then everything we be covered at 30% we would have to pay

the remaining 70%. It sounds cheaper to just self pay. He said self

pay is like about 300 for the visit and about 160 if he needs x-rays.

Does this sound right to everyone? I'm wondering if I could fight the

whole out of network thing and try to get the insurance company just

to cover it, because they do accept aetna in Iowa, its just because we

are not in that local network, etc. Any tips would be appreciated.

Michele Yoder

[Guest guest]

Thanks ! I called and spoke with Mark, he was very nice. He

already called and checked and called me back. He says that it would

be out of network for my Insurance (Aetna) that we have a $1000

deductible then everything we be covered at 30% we would have to pay

the remaining 70%. It sounds cheaper to just self pay. He said self

pay is like about 300 for the visit and about 160 if he needs x-rays.

Does this sound right to everyone? I'm wondering if I could fight the

whole out of network thing and try to get the insurance company just

to cover it, because they do accept aetna in Iowa, its just because we

are not in that local network, etc. Any tips would be appreciated.

Michele Yoder

[Guest guest]

Michele, I am glad you got an answer now you can go from there. Mark

was very helpful to us and I faxed all my info to him also. I would

by all means try to fight it and get them to pay. Don't get

discourged and start doing some phone calls. Before I took

Mark asked me if I had insurance for her and I told him all I had

was state Medicaid but from TX. He was the one who encourged me to

get a referral and try to get Medicaid to pay. He told me it is very

hard to get another state to pay and they probably won't but it's

worth a try after all we had figured her 3 visits would run us over

$1500.00!! And that was just the visits.

So what I did was get my daughters ped to get a referral sent to

Medicaid. I explained to him that we had already seen 2 drs and she

was no getting her feet corrected. So I faxed him a copy of

Dr.Ponseti's email in which he explains what is wrong with her feet

and that she needed to see him personally since there were no drs in

tx that specialised in clubfoot. I think that is what got us

approved. We were approved for 3 visits plus her Ponseti/mitchell

brace!! It was such a blessing! No one could believe that our

Medicaid approved it! So what I am trying to tell is that yeah it

takes some work, time, effort and lots of phone calls but it pays

off in the end. I really hope your insurance approves you and pays

for the visit, even if you do need just one visit. What do you have

to lose, right? I always thought to myself " whats the worst they can

do is say no? " but at least I tried. Please let us know how it goes

and if you do get to see Dr.Ponseti believe you will never regret

it!! I wish you 2 the best!

and

BL CF 12/16/03

BL

nosurgery4clubfoot , " michele_and_collin "

<chele323232@y...> wrote:

> Thanks ! I called and spoke with Mark, he was very nice.

He

> already called and checked and called me back. He says that it

would

> be out of network for my Insurance (Aetna) that we have a $1000

> deductible then everything we be covered at 30% we would have to

pay

> the remaining 70%. It sounds cheaper to just self pay. He said

self

> pay is like about 300 for the visit and about 160 if he needs x-

rays.

> Does this sound right to everyone? I'm wondering if I could fight

the

> whole out of network thing and try to get the insurance company

just

> to cover it, because they do accept aetna in Iowa, its just

because we

> are not in that local network, etc. Any tips would be appreciated.

>

> Michele Yoder

[Guest guest]

Michele, I am glad you got an answer now you can go from there. Mark

was very helpful to us and I faxed all my info to him also. I would

by all means try to fight it and get them to pay. Don't get

discourged and start doing some phone calls. Before I took

Mark asked me if I had insurance for her and I told him all I had

was state Medicaid but from TX. He was the one who encourged me to

get a referral and try to get Medicaid to pay. He told me it is very

hard to get another state to pay and they probably won't but it's

worth a try after all we had figured her 3 visits would run us over

$1500.00!! And that was just the visits.

So what I did was get my daughters ped to get a referral sent to

Medicaid. I explained to him that we had already seen 2 drs and she

was no getting her feet corrected. So I faxed him a copy of

Dr.Ponseti's email in which he explains what is wrong with her feet

and that she needed to see him personally since there were no drs in

tx that specialised in clubfoot. I think that is what got us

approved. We were approved for 3 visits plus her Ponseti/mitchell

brace!! It was such a blessing! No one could believe that our

Medicaid approved it! So what I am trying to tell is that yeah it

takes some work, time, effort and lots of phone calls but it pays

off in the end. I really hope your insurance approves you and pays

for the visit, even if you do need just one visit. What do you have

to lose, right? I always thought to myself " whats the worst they can

do is say no? " but at least I tried. Please let us know how it goes

and if you do get to see Dr.Ponseti believe you will never regret

it!! I wish you 2 the best!

and

BL CF 12/16/03

BL

nosurgery4clubfoot , " michele_and_collin "

<chele323232@y...> wrote:

> Thanks ! I called and spoke with Mark, he was very nice.

He

> already called and checked and called me back. He says that it

would

> be out of network for my Insurance (Aetna) that we have a $1000

> deductible then everything we be covered at 30% we would have to

pay

> the remaining 70%. It sounds cheaper to just self pay. He said

self

> pay is like about 300 for the visit and about 160 if he needs x-

rays.

> Does this sound right to everyone? I'm wondering if I could fight

the

> whole out of network thing and try to get the insurance company

just

> to cover it, because they do accept aetna in Iowa, its just

because we

> are not in that local network, etc. Any tips would be appreciated.

>

> Michele Yoder