Guest guest Posted August 7, 2000 Report Share Posted August 7, 2000 , Hey, I have MAMSI also and I agree that they suck out loud! Have you had the surgery and what did you do to get approved? I am having the worst luck with this insurance stuff. I have everything else ready to go except for my approval. I have thought about becoming a self pay but I am scared of having complications and having a huge medical bill! Please HELP! Re: insurance > > Hey I called my insurance and just asked for the pre authorization > nurse or physician...You do not have to talk to anyone that does not > have medical training. You can demand to talk to the nurse. > > At least I did and I got right through to her but my insurance > company > is MAMSI and I hate that company....they suck out loud...sorry but > they do. > > > > > > > > > > Hi, > > > > I just called my insurance company, Aetna (locally administered), > and > > asked to see if they had received my insurance letter. She said > > nothing was in the computer (no big surprise there) and i am not > sure > > if it has been written and sent because Barb told me Friday she had > > no idea about any of that stuff. I sent my form in for the 2nd tome > > 7 days ago. And I have to admit that I am having a little troule > > watching so many people say they got there letter when they sent > > there form after me. I asked for Barb;s email so I don't have to > > bother her by phone and she can get back to me by email - I would > > still like it if any one has it. > > > > Anyway - My concern with my insurance company, and this is the 2nd > > time they have said this to me, is that they will not tLk to a > > patient about pre-certifcation. My doctor(surgeon) is suppose to > > call and talk to the nurse who pre-certs for gastric bypass. They > > would not put me through to her becasue she only talks to doctors. > > Has anyone else been told this?? Do I just demand?/ I feel like I > > can't even get started. I know they have authorized and paid for > > these before. > > > > Frustrated - > > Laurie > > > > > This message is from the Mini-Gastric Bypass Mailing List at Onelist.com > Please visit our web site at http://clos.net > Get the Patient Manual at http://clos.net/get_patient_manual.htm > > To Unsubscribe Send and Email to: MiniGastricBypass-unsubscribe (AT) egroups (DOT) com > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 22, 2000 Report Share Posted August 22, 2000 Are you from Greenville, SC? I am and also have PHP everyone I know of has been denied they wont cover... if someone knows where they have please let me know also. Thanks, Blanche Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 29, 2004 Report Share Posted January 29, 2004 Robin, I too have questioned this issue, and was told that if it is group insurance, they should cover all preexisting conditions..apparently one gets a letter from the old insurance company and the new insurance company should do the right thing and honour it..not sure if they actually have to... But I also was told that the reason HIPAA was put in place was for this type of thing happening... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 29, 2004 Report Share Posted January 29, 2004 Robin, I'm not sure that the following information would apply when changing jobs, but I think it might. My daughter, Nikki, is getting married in May. She's currently a full time college student so she is covered on her father's insurance, my insurance (only for 31 days after she turns 22, which is today), and my husband's (her stepdad) insurance. Even though her fiance is also still in college, he works enough hours at his job that he has his own health insurance. He can add her to it as soon as they marry. I was really worried about his insurance excluding pre-existing conditions for a period of time. Nikki has asthma, rheumatoid arthritis, ankylosing spondylitis, and an autoimmune clotting disorder. She also has a lot of allergies which end up leading to a lot of sinus infections. Her routine medications cost $450 a month without insurance coverage. That doesn't count any antibiotics or extra meds if she gets sick. Anyway, I called her fiance's insurance to find out if there was going to be an exclusion for pre-existing conditions. They told me that as long as she can prove she had health insurance within 63 prior to be added to his policy, there would be no exclusions for pre-existing conditions. We just have to get a certificate of coverage from her dad's insurance (which is the one that is primary) stating that she had health insurance coverage prior to Nikki and getting married. He just has to bring the certificate of coverage to his human resources dept and then she will be covered with no exclusions for pre-existing conditions. After getting this info from 's insurance, it occurred to me that it might actually be the law that they have to cover you with no exclusions for pre-existing conditions if you had other health insurance coverage. My husband's sis runs her own company and she manages health insurance policies. I asked her about it and she said that it was federal law that they would have to cover Nikki with no exclusions as long as we get the certificate of coverage showing that Nikki had health insurance prior to getting married. She said that part of the law had to do with the new HIPA act, but that there are additional laws covering it as well. I'm not totally sure that this would apply to an employee changing jobs, but I think it might. I think I'd do some research on the internet to find out what your rights are. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 7, 2005 Report Share Posted January 7, 2005 - I WOULD GET INVOLVED WITH THE INSURANCE COMPANY DIRECTLEY, ITS A MAJOR PAIN BUT I THINK THE SQEEKY WHEEL GETTING PAID ATTENTION TO IS A REAL THING. IT TOOK ME MONTHS, IT WAS CRAZY, MY DAUGHTERS SURGEON WAS NOT A COVERED DOC BUT CAUSE IT WAS PREAPPOVE BY ANOTHER INSURANCE AND I MADE THIER LIFE YOU KNOW WHAT PLUS THE SURGEONS BUSINESS OFFICE CALLED AND CALLED THEY FINALLY APPROVED IT ALL. GOOD LUCK MARY -- In orthognathicsurgerysupport , " DWILZEN " <dwilzen@y...> wrote: > > I have blue cross blue shiel government plan. They will not pre > authorize my surgery. I will have to wait and see if they will cover > any of the cost after I have it. Has anyone else encountered this? > Any advice on how to gwt them to pay? SHould I get involved or leave > it up to my os. > thanks Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.