Re: Insurance can be a pain!!

[Guest guest]

Joe,

What a mess - sorry to hear of all the confusion. It seems more and more that insurance & some 02 companies do absolutely nothing to provide support to the patient. I am sure there are some wonderful suppliers, but like you I have not found any of them in my area. Ironically I am in Fayetteville but use Apria in Newan which is about 22 miles away - ironic, huh :-)

Dorothy Reinecke -

To: "Breathe-Support@yahoogrou" <Breathe-Support >Sent: Thursday, September 10, 2009 4:19:37 PMSubject: Insurance can be a pain!!

Hi gang,

A few weeks ago we were notified that Ford Motor Co. (Joanie is retired) was changing from United Health Care to Blue Cross Blue Shield. Shortly after we were sent a letter we had to do a self assessment of our health. After several rounds of being deleted and stopped on the computer while doing so we finally completed the form. Joanie received a response in the mail they received her report. We did not hear about me. Joanie called a couple of weeks ago and they said we were OK and nothing more had to be done. A couple of days ago we got a call saying they needed our reports. After Joanie had a heart to heart with the caller she said she would put in that our reports were completed. Maybe they are in space.

In the meantime we contacted our O2 , c-pap, and concentrator supplier and he said he was approved for Blue Cross and Blue Shield. (no problem right?) We received a bill for over $350 for O2 and they said we were using a company out of network and they would not pay. We took a copy of our bill to our supplier and he said he would find out what the problem was. After a couple of weeks he said Blue Cross Blue Shield had different groups and ours was out of Michigan and we could not use him as a provider. We then went on the Internet and found 5 providers in network. Unfortunately the 3 closest are 23 miles away and our current provider is about 5 miles. Joanie called the provider in Fayetteville and they said they needed new prescriptions for for O2, c-pap, and concentrator. We went to our local pulmo and he wrote a prescription for O2 therapy and c-pap supplies as I own the c-pap. After faxing the prescription the called and

said they could not provide the O2 without a current 6 minute walk (last 90 days) test results. I called Emory and a wonderful Tech (Mari Hart) said to come up at noon today and she would slide me in. I did a 2 minute walk and she stopped me after I dropped to 80%. She then went to the Dr. and he wrote a prescription for O2 and all of the supplies,concentrat or, bottles, etc. I returned home faxed the prescription to the new provider.

They now want me to come over and be fitted for the c-pap mask before providing one. This is 23 miles, Emory was about 40 miles and I have to pay for the gas not to mention the aggravation. Emory was kind enough to give me a token for parking otherwise it would have cost me another $4.00

If I need extra bottles in a hurry at a late time I am screwed., and the owner of my present provider gave me his cell # and I did call him once when on vacation and he responded quickly giving me a great feeling of security.

This is the type of insurance help we need. Stop the harassment. If a person has been on O2 for over a year and a half and has IPF, do you think a miracle has happened and it suddenly has disappeared.

This also raises my BP too.

Joe

   JOE & JOANIE LAMENSKIE

IPF JAN. 2008

[Guest guest]

Joe

I don't normally recommend providers because they vary so by area.

However, in terms of flexibility and coverage, Lincare has around 30

locations in Georgia. Many of us do use them in our areas. I would think

there would be very few insurance companies they wouldn't have

agreements with.

Similarly, Apria would have agreements and coverage. I just could never

recommend them. Their overall history of service nationwide isn't good,

although in specific locations we have board members who love them.

Another reminder. Many local providers are struggling significantly with

the reductions in the medicare rate this year. I had a good local

provider but when they started warning their employees, freezing wages

and cutting back I was scared of 18 months down the road. We know

Lincare is profitable although still cutting costs because of the huge

revenue loss from the medicare reduction. As a practical matter, we

don't know that any other oxygen provider is profitable today. Thats

allowing the large ones and newer players such as Walgreens and Lincare

to buy many of them. Apria and American Home Patient have also

traditionally done a lot of acquisitions although I can't say today.

I hope the outlook for the industry is better than I perceive.

Back to Joe. I hate we have to fight to get what we need, but we must

not settle for any less.

>

> Hi gang,

>

> A few weeks ago we were notified that Ford Motor Co. (Joanie is

> retired) was changing from United Health Care to Blue Cross Blue

Shield.

> Shortly after we were sent a letter we had to do a self assessment of

our

> health. After several rounds of being deleted and stopped on the

computer

> while doing so we finally completed the form. Joanie received a

response in

> the mail they received her report. We did not hear about me. Joanie

called a

> couple of weeks ago and they said we were OK and nothing more had to

be done

> A couple of days ago we got a call saying they needed our reports.

After

> Joanie had a heart to heart with the caller she said she would put in

that

> our reports were completed. Maybe they are in space.

> In the meantime we contacted our O2 , c-pap, and concentrator

supplier

> and he said he was approved for Blue Cross and Blue Shield. (no

problem

> right?) We received a bill for over $350 for O2 and they said we were

using

> a company out of network and they would not pay. We took a copy of our

bill

> to our supplier and he said he would find out what the problem was.

After a

> couple of weeks he said Blue Cross Blue Shield had different groups

and ours

> was out of Michigan and we could not use him as a provider. We then

went on

> the Internet and found 5 providers in network. Unfortunately the 3

closest

> are 23 miles away and our current provider is about 5 miles. Joanie

called

> the provider in Fayetteville and they said they needed new

prescriptions for

> for O2, c-pap, and concentrator. We went to our local pulmo and he

wrote a

> prescription for O2 therapy and c-pap supplies as I own the c-pap.

After

> faxing the prescription the called and said they could not provide the

O2

> without a current 6 minute walk (last 90 days) test results. I called

Emory

> and a wonderful Tech (Mari Hart) said to come up at noon today and she

would

> slide me in. I did a 2 minute walk and she stopped me after I dropped

to 80%

> She then went to the Dr. and he wrote a prescription for O2 and all

of the

> supplies,concentrator, bottles, etc. I returned home faxed the

prescription

> to the new provider.

> They now want me to come over and be fitted for the c-pap mask

before

> providing one. This is 23 miles, Emory was about 40 miles and I have

to pay

> for the gas not to mention the aggravation. Emory was kind enough to

give

> me a token for parking otherwise it would have cost me another $4.00

> If I need extra bottles in a hurry at a late time I am screwed.,

and

> the owner of my present provider gave me his cell # and I did call him

once

> when on vacation and he responded quickly giving me a great feeling of

> security.

> This is the type of insurance help we need. Stop the harassment.

If a

> person has been on O2 for over a year and a half and has IPF, do you

think a

> miracle has happened and it suddenly has disappeared.

> This also raises my BP too.

>

> Joe

>   

> JOE & JOANIE LAMENSKIE

> IPF JAN. 2008

>

[Guest guest]

Joe, I am so sorry, insurance companys are ****ing idiots sometimes. If you know what mask you wear and want you can order over the internet. All you need to do is fax/pdf them a copy of the script for cpap supplies and it is good for 99 years. I use CPAP Supply USA out of Midlothian VA. They are very good and fast and will send you all the info you need to file an ins claim for whatever you buy. Hope this helps.Dyane Phoenix ipf 02>> Hi gang,

> > A few weeks ago we were notified that Ford Motor Co. (Joanie is> retired) was changing from United Health Care to Blue Cross Blue Shield.> Shortly after we were sent a letter we had to do a self assessment of our> health. After several rounds of being deleted and stopped on the computer> while doing so we finally completed the form. Joanie received a response in> the mail they received her report. We did not hear about me. Joanie called a> couple of weeks ago and they said we were OK and nothing more had to be done> A couple of days ago we got a call saying they needed our reports. After> Joanie had a heart to heart with the caller she said she would put in that> our reports were completed. Maybe they are in space.

> In the meantime we contacted our O2 , c-pap, and concentrator supplier> and he said he was approved for Blue Cross and Blue Shield. (no problem> right?) We received a bill for over $350 for O2 and they said we were using> a company out of network and they would not pay. We took a copy of our bill> to our supplier and he said he would find out what the problem was. After a> couple of weeks he said Blue Cross Blue Shield had different groups and ours> was out of Michigan and we could not use him as a provider. We then went on> the Internet and found 5 providers in network. Unfortunately the 3 closest> are 23 miles away and our current provider is about 5 miles. Joanie called> the provider in Fayetteville and they said they needed new prescriptions for> for O2, c-pap, and concentrator. We went to our local pulmo and he wrote a> prescription for O2 therapy and c-pap supplies as I own the c-pap. After> faxing the prescription the called and said they could not provide the O2> without a current 6 minute walk (last 90 days) test results. I called Emory> and a wonderful Tech (Mari Hart) said to come up at noon today and she would> slide me in. I did a 2 minute walk and she stopped me after I dropped to 80%> She then went to the Dr. and he wrote a prescription for O2 and all of the> supplies,concentrator, bottles, etc. I returned home faxed the prescription> to the new provider.

> They now want me to come over and be fitted for the c-pap mask before> providing one. This is 23 miles, Emory was about 40 miles and I have to pay> for the gas not to mention the aggravation. Emory was kind enough to give> me a token for parking otherwise it would have cost me another $4.00 > If I need extra bottles in a hurry at a late time I am screwed., and> the owner of my present provider gave me his cell # and I did call him once> when on vacation and he responded quickly giving me a great feeling of> security.

> This is the type of insurance help we need. Stop the harassment. If a> person has been on O2 for over a year and a half and has IPF, do you think a> miracle has happened and it suddenly has disappeared.

> This also raises my BP too.

> > Joe

>    > JOE & JOANIE LAMENSKIE

> IPF JAN. 2008>

[Guest guest]

Joe,

There is a Lincare in Newnan - don't know if there is one closer to you. I have been considering a change to Lincare.

I cannot recommend Apria - while I do have good luck with them providing supplies when I visit my family in the north east,

the service locally is not good.

Take care and don't give up - You deserve the very best and unfortunately we need to demand it.

Let me know when you and Joanie can plan lunch/brunch after 9/21.

Dorothy Reinecke

Fayetteville, GA (20 miles south of Atlanta)

VATS 7/05 - UIP 7/05

From: Breathe-Support [mailto:Breathe-Support ] On Behalf Of brucemorelandSent: Thursday, September 10, 2009 4:32 PMTo: Breathe-Support Subject: Re: Insurance can be a pain!!

JoeI don't normally recommend providers because they vary so by area.However, in terms of flexibility and coverage, Lincare has around 30locations in Georgia. Many of us do use them in our areas. I would thinkthere would be very few insurance companies they wouldn't haveagreements with.Similarly, Apria would have agreements and coverage. I just could neverrecommend them. Their overall history of service nationwide isn't good,although in specific locations we have board members who love them.Another reminder. Many local providers are struggling significantly withthe reductions in the medicare rate this year. I had a good localprovider but when they started warning their employees, freezing wagesand cutting back I was scared of 18 months down the road. We knowLincare is profitable although still cutting costs because of the hugerevenue loss from the medicare reduction. As a practical matter, wedon't know that any other oxygen provider is profitable today. Thatsallowing the large ones and newer players such as Walgreens and Lincareto buy many of them. Apria and American Home Patient have alsotraditionally done a lot of acquisitions although I can't say today.I hope the outlook for the industry is better than I perceive.Back to Joe. I hate we have to fight to get what we need, but we mustnot settle for any less.>> Hi gang,>> A few weeks ago we were notified that Ford Motor Co. (Joanie is> retired) was changing from United Health Care to Blue Cross BlueShield.> Shortly after we were sent a letter we had to do a self assessment ofour> health. After several rounds of being deleted and stopped on thecomputer> while doing so we finally completed the form. Joanie received aresponse in> the mail they received her report. We did not hear about me. Joaniecalled a> couple of weeks ago and they said we were OK and nothing more had tobe done> A couple of days ago we got a call saying they needed our reports.After> Joanie had a heart to heart with the caller she said she would put inthat> our reports were completed. Maybe they are in space.> In the meantime we contacted our O2 , c-pap, and concentratorsupplier> and he said he was approved for Blue Cross and Blue Shield. (noproblem> right?) We received a bill for over $350 for O2 and they said we wereusing> a company out of network and they would not pay. We took a copy of ourbill> to our supplier and he said he would find out what the problem was.After a> couple of weeks he said Blue Cross Blue Shield had different groupsand ours> was out of Michigan and we could not use him as a provider. We thenwent on> the Internet and found 5 providers in network. Unfortunately the 3closest> are 23 miles away and our current provider is about 5 miles. Joaniecalled> the provider in Fayetteville and they said they needed newprescriptions for> for O2, c-pap, and concentrator. We went to our local pulmo and hewrote a> prescription for O2 therapy and c-pap supplies as I own the c-pap.After> faxing the prescription the called and said they could not provide theO2> without a current 6 minute walk (last 90 days) test results. I calledEmory> and a wonderful Tech (Mari Hart) said to come up at noon today and shewould> slide me in. I did a 2 minute walk and she stopped me after I droppedto 80%> She then went to the Dr. and he wrote a prescription for O2 and allof the> supplies,concentrator, bottles, etc. I returned home faxed theprescription> to the new provider.> They now want me to come over and be fitted for the c-pap maskbefore> providing one. This is 23 miles, Emory was about 40 miles and I haveto pay> for the gas not to mention the aggravation. Emory was kind enough togive> me a token for parking otherwise it would have cost me another $4.00> If I need extra bottles in a hurry at a late time I am screwed.,and> the owner of my present provider gave me his cell # and I did call himonce> when on vacation and he responded quickly giving me a great feeling of> security.> This is the type of insurance help we need. Stop the harassment.If a> person has been on O2 for over a year and a half and has IPF, do youthink a> miracle has happened and it suddenly has disappeared.> This also raises my BP too.>> Joe>   > JOE & JOANIE LAMENSKIE> IPF JAN. 2008>

[Guest guest]

I do not think there is a lincare closer but I did not see them on our Blue Cross list either.

Hope I did not come off too pissed as I WAS. Sorry to dump but Joanie is as frustrated as I was so I tried to help keep her down to earth. Sorry as I had to leave as we had company.

Joe

   JOE & JOANIE LAMENSKIE

IPF JAN. 2008

-- RE: Re: Insurance can be a pain!!

Joe,

There is a Lincare in Newnan - don't know if there is one closer to you. I have been considering a change to Lincare.

I cannot recommend Apria - while I do have good luck with them providing supplies when I visit my family in the north east,

the service locally is not good.

Take care and don't give up - You deserve the very best and unfortunately we need to demand it.

Let me know when you and Joanie can plan lunch/brunch after 9/21.

Dorothy Reinecke

Fayetteville, GA (20 miles south of Atlanta)

VATS 7/05 - UIP 7/05

From: Breathe-Support [mailto:Breathe-Support ] On Behalf Of brucemorelandSent: Thursday, September 10, 2009 4:32 PMTo: Breathe-Support Subject: Re: Insurance can be a pain!!

JoeI don't normally recommend providers because they vary so by area.However, in terms of flexibility and coverage, Lincare has around 30locations in Georgia. Many of us do use them in our areas. I would thinkthere would be very few insurance companies they wouldn't haveagreements with.Similarly, Apria would have agreements and coverage. I just could neverrecommend them. Their overall history of service nationwide isn't good,although in specific locations we have board members who love them.Another reminder. Many local providers are struggling significantly withthe reductions in the medicare rate this year. I had a good localprovider but when they started warning their employees, freezing wagesand cutting back I was scared of 18 months down the road. We knowLincare is profitable although still cutting costs because of the hugerevenue loss from the medicare reduction. As a practical matter, wedon't know that any other oxygen provider is profitable today. Thatsallowing the large ones and newer players such as Walgreens and Lincareto buy many of them. Apria and American Home Patient have alsotraditionally done a lot of acquisitions although I can't say today.I hope the outlook for the industry is better than I perceive.Back to Joe. I hate we have to fight to get what we need, but we mustnot settle for any less.>> Hi gang,>> A few weeks ago we were notified that Ford Motor Co. (Joanie is> retired) was changing from United Health Care to Blue Cross BlueShield.> Shortly after we were sent a letter we had to do a self assessment ofour> health. After several rounds of being deleted and stopped on thecomputer> while doing so we finally completed the form. Joanie received aresponse in> the mail they received her report. We did not hear about me. Joaniecalled a> couple of weeks ago and they said we were OK and nothing more had tobe done> A couple of days ago we got a call saying they needed our reports.After> Joanie had a heart to heart with the caller she said she would put inthat> our reports were completed. Maybe they are in space.> In the meantime we contacted our O2 , c-pap, and concentratorsupplier> and he said he was approved for Blue Cross and Blue Shield. (noproblem> right?) We received a bill for over $350 for O2 and they said we wereusing> a company out of network and they would not pay. We took a copy of ourbill> to our supplier and he said he would find out what the problem was.After a> couple of weeks he said Blue Cross Blue Shield had different groupsand ours> was out of Michigan and we could not use him as a provider. We thenwent on> the Internet and found 5 providers in network. Unfortunately the 3closest> are 23 miles away and our current provider is about 5 miles. Joaniecalled> the provider in Fayetteville and they said they needed newprescriptions for> for O2, c-pap, and concentrator. We went to our local pulmo and hewrote a> prescription for O2 therapy and c-pap supplies as I own the c-pap.After> faxing the prescription the called and said they could not provide theO2> without a current 6 minute walk (last 90 days) test results. I calledEmory> and a wonderful Tech (Mari Hart) said to come up at noon today and shewould> slide me in. I did a 2 minute walk and she stopped me after I droppedto 80%> She then went to the Dr. and he wrote a prescription for O2 and allof the> supplies,concentrator, bottles, etc. I returned home faxed theprescription> to the new provider.> They now want me to come over and be fitted for the c-pap maskbefore> providing one. This is 23 miles, Emory was about 40 miles and I haveto pay> for the gas not to mention the aggravation. Emory was kind enough togive> me a token for parking otherwise it would have cost me another $4.00> If I need extra bottles in a hurry at a late time I am screwed.,and> the owner of my present provider gave me his cell # and I did call himonce> when on vacation and he responded quickly giving me a great feeling of> security.> This is the type of insurance help we need. Stop the harassment.If a> person has been on O2 for over a year and a half and has IPF, do youthink a> miracle has happened and it suddenly has disappeared.> This also raises my BP too.>> Joe>   > JOE & JOANIE LAMENSKIE> IPF JAN. 2008>