Guest guest Posted July 28, 2008 Report Share Posted July 28, 2008 Hi - I'm sorry to hear about your frustration with the insurance process at CT. I can tell you that I had a similar issue (not a hard sell, but paying up front and getting misinformation) and it is the one negative experience I had with CT throughout the 6 months we've worked with them. I'm not sure what insurance you have but we have BCBS of NC federal employee program. CT was out of network for us but I still had coverage at 75% after our deductible. I knew all of this going in. What I then learned from the insurance specialist at the Charlotte office was that because they were considered out of network, that I would have to pay up front (either in full or in 4 monthly payments) and then submit my own claim for reimbursement to BCBS. I was okay with that, I mean, not thrilled but I really had no other choice. Then she proceeded to tell me that her experience with BCBS of NC was that they typically only payed around 600 bucks before the deductible, in other words, around $225. She did say that she hadn't worked with the FEP before, but that's what regular BCBS of NC typically paid. I knew the cost was $3300 (the price just went up to $3600 a few months ago) and she told me that if I paid in full up front, it would be $3000 and she told me all about the Care Credit card with 0% interest for 18 months. I already had a Care Credit card so I thought great, I'll use that and all will be good. My son was almost 17 months old, so I just wanted to get the ball rolling. Well, the day of the casting, I'm told that I owe $3300 because I'm using the Care Credit card. Here it turns out that the $300 discount only pertains to OTHER credit cards besides Care Credit (they apparently charge a $300 fee per transaction). So I was really annoyed because although I had another credit card I could use, I wasn't sure if I had $3000 in available credit (it was just after the holidays). Thankfully, it went through (barely!), but then I'm getting charged interest. Had it been stated to me more clearly over the phone, I would have looked into getting a new 0% interest card prior to the casting. Then I submit my claim to BCBS/FEP (I did need a letter of medical necessity as well, which I had from a craniofacial surgeon) and within 2 weeks got a reimbursement check for a little more than $2100, exactly 75% of $3000 after our deductible, and a far cry from the measely $225 the insurance specialist had told me I would get. So in the end, all that annoyance and aggrevation in the beginning was for naught. Unfortunately, I was given some misinformation that made it a little more stressful on me than necessary. The good news was that in the end, it was really just a minor inconvenience and a small misstep in an otherwise fantastic experience. I assume that if CT won't file your claim it's because they are out of network with your insurance, which seems to be their standard practice. It sounds like if your insurance is going to cover it 100%, then you should get back the full $3600 in the end (or $3300 if they still offer the discount for paying in full), so don't trust what they tell you at CT, double check and triple check it all with your insurance company directly (I called BCBS/FEP 3 times to get an explanation of the coverage from 3 different people and documented each call to have for later if I needed it). My insurance company had no problem with me submitting the claim myself, so I'm not sure what to do about yours telling you not to pay up front. Sorry for such a long response, but I wanted to let you know that I've been in a similar situation and that it all worked out. I really hope it works out for you too. Good luck! Jake-22m (tort resolved/rt plagio/DOCBand #2 8 weeks) Jordan-4 > > > > > > > > > > > > > > My daughter is now six months old. At 4 months we started > > PT > > > > for > > > > > her > > > > > > > torticollis. It has responded somewhat, but not enough. > > This > > > > week > > > > > my > > > > > > > ped. referred us to a neurologist who recommends the > > Starband > > > > b/c > > > > > of > > > > > > > her facial asymmentry.. ... my questions > > > > > > > > > > > > > > - Although we have had an x-ray, should we still have an > > MRI to > > > > > rule > > > > > > > out any underlying issues? The neurologist said he was on > > the > > > > > fence > > > > > > > about it since it involved sedation. > > > > > > > > > > > > > > - Has anyone had a good/bad experience w/ the STARband in > > > > > Columbia, Md? > > > > > > > Should I drive little further and do a DOC band instead? > > > > > > > > > > > > > > - I plan to get a second opinion from another > neurologist. > > Has > > > > > anyone > > > > > > > ever gone to Dr. Ahn (Hopkins) or Kenney Kreiger..any > > > > > recommendations. > > > > > > > > > > > > > > Thanks! > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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