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Tuesday, March 16, 2010

Insurance Update

After my post last month regarding the insurance issues (to put it nicely), I made a LOT of phone calls.  Surprisingly Medtronic, the company that makes the stimulator, jumped right on it and said they would start an appeal case for me.  I didn't even have to do anything!  Talk about good customer service...that company is tops.  I hadn't heard from them in weeks and decided that no news was good news, but then they called the other day.  The rep told me that they had tried to appeal my case but since my other doctor (surgeon) had already appealed it 3 times unsuccessfully, appeals had been exhausted and there was nothing Medtronic could do, so they put the issue back in my hands.  However, the insurance company did tell them that I could submit an appeal myself, and that personal appeals from patients usually weigh in a bit heavier than appeals from doctors (yeah right).  So I am supposed to write them a letter and put everything in it...my history, prior treatments, stimulator experience, and of course why I feel they should pay, including any paperwork I have.  This all seems silly and redundant to me, since I had to give them most of that to get the darn thing approved in the first place but whatever, I guess it's better than dealing with a lawyer.

Being long-winded as I am, I decided that if they want everything, I'll give them everything.  I've already begun writing my appeal and have 5 pages.  I have a feeling it'll be at least 10 by the time I'm done.  They want paperwork?  They'll get paperwork.  I have a lot of it.  Plus I'm a government employee and we are masters of paperwork.

I have a feeling this might turn into a long battle, but I'm ready to fight it.  I still stand by my assertion that $12,000 is nothing to an insurance company, but it's a lot to me and therefore this is worth the effort.

And people think we don't need healthcare reform in this country...

1 comments:

WinnyNinny PooPoo said...

By pre-approving and then denying the claim, the insurance company has some culpability here. Make sure you emphasize this. Many insurance companies have internal policies if the insured can track something down to an error in communication they have funds to pay those claims....