Re: Re: Doctors who lie and say they use the method!

[Guest guest]

Michele,

You may not have it in writing but they probably do. (They probably even have a

recording of the conversation.) If you could find one person who is somewhat

sympathetic to you (just keep calling and talking to different people and put on

your best " oh woe is me " thing) you may be able to get them to fax you whatever

documentation they have in the file regarding your request. I'm just throwing

stuff out there now....what if you had your pediatrician's office call and say

that they need all the documentation they have regarding this matter?

I don't know if this is helpful at all, but just wanted you to know I feel for

you -- doesn't customer service suck??? And whose idea was it to create a job

specifically for someone to *try* to deny customer's claims?

Keeping my fingers crossed for you,

le_and_collin wrote:

I just found out now, that even know we were told we had approval,

etc...we are now denied! I think that is such BS. I didn't have it

in writing though, dummy me. But Collin's peds.office should have it

in his chart which should help. It is all because the doctors around

here lie and say they do the method. I can't do much more about it

tonight, so I will start again tommorow. It turns out some lady they

call a nurse researches it for our case manager, she found out the

info. then gave it to a Dr. Rosen that they say is a peditrician they

have on staff at Aetna (I said well does he treat patients? - and she

said no he wouldn't have the time, capicity, etc...because he is busy

working for Aetna). So now I have to have the doctors call this Dr.

Rosen and start over again. And start the appeal process. I am going

to fight this one, because how dare they give me permission then take

it away. You think they would want to learn about the method,

etc...but they just don't care to so far at Aenta, I feel it goes in

one ear and out the other.

Michele

[Guest guest]

Michele,

You may not have it in writing but they probably do. (They probably even have a

recording of the conversation.) If you could find one person who is somewhat

sympathetic to you (just keep calling and talking to different people and put on

your best " oh woe is me " thing) you may be able to get them to fax you whatever

documentation they have in the file regarding your request. I'm just throwing

stuff out there now....what if you had your pediatrician's office call and say

that they need all the documentation they have regarding this matter?

I don't know if this is helpful at all, but just wanted you to know I feel for

you -- doesn't customer service suck??? And whose idea was it to create a job

specifically for someone to *try* to deny customer's claims?

Keeping my fingers crossed for you,

le_and_collin wrote:

I just found out now, that even know we were told we had approval,

etc...we are now denied! I think that is such BS. I didn't have it

in writing though, dummy me. But Collin's peds.office should have it

in his chart which should help. It is all because the doctors around

here lie and say they do the method. I can't do much more about it

tonight, so I will start again tommorow. It turns out some lady they

call a nurse researches it for our case manager, she found out the

info. then gave it to a Dr. Rosen that they say is a peditrician they

have on staff at Aetna (I said well does he treat patients? - and she

said no he wouldn't have the time, capicity, etc...because he is busy

working for Aetna). So now I have to have the doctors call this Dr.

Rosen and start over again. And start the appeal process. I am going

to fight this one, because how dare they give me permission then take

it away. You think they would want to learn about the method,

etc...but they just don't care to so far at Aenta, I feel it goes in

one ear and out the other.

Michele

[Guest guest]

Michele,

How frustrating!!! Besides, even if they do use the Ponseti Method, that

is not the point. They aren't as good as Ponseti himself and Herzenberg.

Your son has a special circumstance and has already been screwed up by the

locals hence the purpose of going to the absolute best anyway. Call the

insurance company back and start from the very beginning of story,

cry, and keep on going!!!! Don't let them bully you. Man, I am so bumbed

for you.

Hang in there and keep fighting.

Shook

Retail Operations Manager/Baking Instructor

Vie de France Yamazaki, Inc.

2070 Chain Bridge Rd. Suite 500

Vienna, VA 22182

x374

x374

fax

[Guest guest]

Michele,

I was having insurance problems after Kelsey was born

because that because she was born a " sick " child, that

her newborn care wasn't covered under my copay and we

owed another copay for her. Never mind that her

" sickness " was that she was born with clubfoot and

they didn't do squat about that in the hospital.

ANyway, I finally got sick of the whole phone call

crap because everyone kept giving me a different

story. I finally bypassed it all and went through the

formal appeals process with a written appeal. After

this, we won the appeal because they were truly in the

wrong. I would look into Aetna's formal appeals

process and in writing, submit to them everything that

you have. Tell them that you had been given approval

prior, who gave it to you if you remember and if

possible, attach something in writing from your

pediatrician. I would also submit a list of the

certified Doctors to show whatever you can in writing.

I think that sometimes this is the only way insurance

companies take people seriously because they think

you'll just give up. I have a hideous temper also so

putting things in writing prevents me from blowing up

and calling the insurance people things that I

shouldn't repeat although I have done that a time or

two as well. I would definitely file a formal appeal.

Jenni

--- michele_and_collin wrote:

> I just found out now, that even know we were told we

> had approval,

> etc...we are now denied! I think that is such BS.

> I didn't have it

> in writing though, dummy me. But Collin's

> peds.office should have it

> in his chart which should help. It is all because

> the doctors around

> here lie and say they do the method. I can't do

> much more about it

> tonight, so I will start again tommorow. It turns

> out some lady they

> call a nurse researches it for our case manager, she

> found out the

> info. then gave it to a Dr. Rosen that they say is a

> peditrician they

> have on staff at Aetna (I said well does he treat

> patients? - and she

> said no he wouldn't have the time, capicity,

> etc...because he is busy

> working for Aetna). So now I have to have the

> doctors call this Dr.

> Rosen and start over again. And start the appeal

> process. I am going

> to fight this one, because how dare they give me

> permission then take

> it away. You think they would want to learn about

> the method,

> etc...but they just don't care to so far at Aenta, I

> feel it goes in

> one ear and out the other.

>

> Michele

>

>

>

Jenni-

Mom to (10/31/01) and Kelsey (11/7/03)happy girl in DBB nights only for

left clubfoot.

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