Re: Insurance can be a pain!!

[Guest guest]

I agree wholeheartedly about BCBS and other insurance companies. All of these insurance companies specialize in how many "STALLING TATICS" they can apply to each claim.

Toodles!

Jane UIP/IPF 12/1998 Dalton, Georgia aka pianolady_musicgirl

> > We did get approved for the O2 after my 2 minute walk. I have the new > equipment from the company in Fayetteville. Years ago I had several > bad experiences with BCBS when I worked for G.E.. They were the > paperwork shuffler as G.E. was self insured. If there was ANYTHING > to cause a delay they used it. This included a signature that was > different such as Joe versus ph, a word that was misspelled, a > word handwritten that they said they could not read etc. I finally > had to go through G.E. channels to help. This went on so far as > doctors and hospitals sent bills in for collection. It was blatant > attempts to delay payment and several were thousands for my kids > surgeries. I told Joanie when we were notified that we were changing > from United Health Care to BCBS I hoped the experience was more > pleasant. So far no improvement. I feel this is the type change we > need in health insurance is to keep them from jerking people around. > I think these examples are the reason we have seen people go postal.> Joe> >   > JOE & JOANIE LAMENSKIE> IPF JAN. 2008> <53_c_link.gif>> -- Re: Insurance can be a pain!!> > > Dear Joe and Joanie,> Perhaps it would help if you sent a letter to the head of BCBS and > let them know the run around you had.> > My experience with BCBS is they finally paid my emergency room visit > for a possible pulmonary embolism after three paperwork submissions.> I was thankful that they finally paid, but the amount of stress they > caused me in the meantime is really uncalled for.> > I don't use O2 yet and hope that's a long time down the road.> But sometimes I wish people could experience the SOB, the O2 use, the > physical way we feel from this disease and then maybe we would get a > kinder response from our health insurance companies.> > PJ in Ohio, 54, IPF '09, Sjogren's '95> > 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,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> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > <imstp_animation_monkey_en_020908.gif>>

[Guest guest]

Joanie and I had very little trouble with United Health Care. That is why we were upset as we did not want to change.

   JOE & JOANIE LAMENSKIE

IPF JAN. 2008

-- Re: Insurance can be a pain!!> > > Dear Joe and Joanie,> Perhaps it would help if you sent a letter to the head of BCBS and > let them know the run around you had.> > My experience with BCBS is they finally paid my emergency room visit > for a possible pulmonary embolism after three paperwork submissions.> I was thankful that they finally paid, but the amount of stress they > caused me in the meantime is really uncalled for.> > I don't use O2 yet and hope that's a long time down the road.> But sometimes I wish people could experience the SOB, the O2 use, the > physical way we feel from this disease and then maybe we would get a > kinder response from our health insurance companies.> > PJ in Ohio, 54, IPF '09, Sjogren's '95> > 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,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> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > <imstp_animation_monkey_en_020908.gif>>

[Guest guest]

I guess I have been very lucky with our insurance (BCBS through my husband's retirement from the Los Angeles Sheriff's department). They have almost always paid without a problem.. my oxygen, CPap, tests, ER/hospital visits. When I have had a problem, it was due to a paperwork problem on the doctor or hospital's end.I'm sorry to hear of all the problems you all are having. It saddens me that the companys WE pay to supply us with a service make it so difficult!Alice LynneMother to threeGrandmother to twoWife to oneAutoimmune hypersensitivity pneumonitis w/pulmonary fibrosisSent from my iPhoneOn Sep 14, 2009, at 11:14 AM, "JOE & JOANIE LAMENSKIE"

wrote:

Joanie and I had very little trouble with United Health Care. That is why we were upset as we did not want to change.

   JOE & JOANIE LAMENSKIE

IPF JAN. 2008

<53_c_link.gif>

-- Re: Insurance can be a pain!!> > > Dear Joe and Joanie,> Perhaps it would help if you sent a letter to the head of BCBS and > let them know the run around you had.> > My experience with BCBS is they finally paid my emergency room visit > for a possible pulmonary embolism after three paperwork submissions.> I was thankful that they finally paid, but the amount of stress they > caused me in the meantime is really uncalled for.> > I don't use O2 yet and hope that's a

long time down the road.> But sometimes I wish people could experience the SOB, the O2 use, the > physical way we feel from this disease and then maybe we would get a > kinder response from our health insurance companies.> > PJ in Ohio, 54, IPF '09, Sjogren's '95> > 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,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> > > > > > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > <imstp_animation_monkey_en_020908.gif>>

<imstp_animation_panda_en_020908.gif>

[Guest guest]

We have another chapter and this time due to the surgery center. Three weeks ago I had carpal tunnel surgery on my left hand. We got a statement that the surgery center sent it in as Joanie having the surgery. The surgery center said they had a new girl and she screwed up 3 different billing statements. Now this will give BCBS a reason top delay when they get the new bill. Aren't insurance companies wonderful?

Joe

   JOE & JOANIE LAMENSKIE

IPF JAN. 2008

-- Re: Insurance can be a pain!!> > > Dear Joe and Joanie,> Perhaps it would help if you sent a letter to the head of BCBS and > let them know the run around you had.> > My experience with BCBS is they finally paid my emergency room visit > for a possible pulmonary embolism after three paperwork submissions.> I was thankful that they finally paid, but the amount of stress they > caused me in the meantime is really uncalled for.> > I don't use O2 yet and hope that's a long time down the road.> But sometimes I wish people could experience the SOB, the O2 use, the > physical way we feel from this disease and then maybe we would get a > kinder response from our health insurance companies.> > PJ in Ohio, 54, IPF '09, Sjogren's '95> > 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,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> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > <imstp_animation_monkey_en_020908.gif>>

[Guest guest]

Odd thing is that a few years back Aetna had a major suit against them

started in Texas. Ultimately they agreed not to make the changes they

had proposed and doctors objected to. Now, I find that interesting,

because I was on Aetna after that for five years and never had a single

problem with them. Only claims that were problems were one doctor's

office kept screwing up and putting one doctor's name with another's

number, so they'd send it back and forth.

So, I think it depends on companies and locations and policy. Through

businesses most of the time the policy may dictate less coverage because

the business chose it that way to save money. Many times the insurance

company is just an administrator.

Also for those mentioning BC/BS, one very important thing. This isn't

one company. It's many different entities. I actually knew companies in

Miami using Empire Blue Cross and Blue Shield from NY. Talk about

problems dealing with insurer and doctors unfamiliar with each other. I

had a Florida policy with Humana when I moved to Texas and had a pain

until I got with the right VP. Couldn't get the book of providers

because Texas said i should get from Florida and, of course, Florida

providers didn't help in Texas.

Then one more issue that is so commonplace. Providers having a contract

with the insurance company and after collecting properly from the

contract amount (from you and insurer) then charging still a balance.

They're just trying to get something they're not due in that case. The

worst appear to be those you never contracted directly to like

radiologists and other providers in the hospital. I once had a local

hospital keep saying I owed. The insurer agreed that they and I had paid

the contract amount. Finally they called the hospital and pointed out

their violation of the contract. Matter was settled, nothing owed.

Now, the fad is for medical providers to quickly turn over to collection

bureaus. This puts it on your credit report and regardless of you paying

it or not, you still have a negative reporting. I know one large

mortgage company circulating petitions for the Medical Debt Relief Act

of 2009. I don't know that such a bill has even been presented but the

point is they want a requirement that medical bills must be removed from

your credit report within 30 days of you paying or settling them and all

derogatory remarks removed. I once had $2.37 showing on my credit report

three times, from the provider and two collection bureaus. This was an

amount the provider agreed was a miscalculation. But, regardless,

getting the three items on three credit bureaus corrected and removed

would have been a great deal of work. But lets say i'd really owed it.

Paying it would not have removed it. It still would have shown three

times as a late payment and collection item.

> >

> > We did get approved for the O2 after my 2 minute walk. I have the

new

> > equipment from the company in Fayetteville. Years ago I had several

> > bad experiences with BCBS when I worked for G.E.. They were the

> > paperwork shuffler as G.E. was self insured. If there was ANYTHING

> > to cause a delay they used it. This included a signature that was

> > different such as Joe versus ph, a word that was misspelled, a

> > word handwritten that they said they could not read etc. I finally

> > had to go through G.E. channels to help. This went on so far as

> > doctors and hospitals sent bills in for collection. It was blatant

> > attempts to delay payment and several were thousands for my kids

> > surgeries. I told Joanie when we were notified that we were changing

> > from United Health Care to BCBS I hoped the experience was more

> > pleasant. So far no improvement. I feel this is the type change we

> > need in health insurance is to keep them from jerking people around.

> > I think these examples are the reason we have seen people go postal.

> > Joe

> >

> >   

> > JOE & JOANIE LAMENSKIE

> > IPF JAN. 2008

> > <53_c_link.gif>

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

> >

> >

> > Dear Joe and Joanie,

> > Perhaps it would help if you sent a letter to the head of BCBS and

> > let them know the run around you had.

> >

> > My experience with BCBS is they finally paid my emergency room visit

> > for a possible pulmonary embolism after three paperwork submissions.

> > I was thankful that they finally paid, but the amount of stress they

> > caused me in the meantime is really uncalled for.

> >

> > I don't use O2 yet and hope that's a long time down the road.

> > But sometimes I wish people could experience the SOB, the O2 use,

the

> > physical way we feel from this disease and then maybe we would get a

> > kinder response from our health insurance companies.

> >

> > PJ in Ohio, 54, IPF '09, Sjogren's '95

> >

> > Insurance can be a pain!!

> >

> >

> >

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> >

> > 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

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> > <imstp_animation_monkey_en_020908.gif>

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