Re: Shriner's billing/Kaiser Insurance

[Guest guest]

BS! I so agree, Jane, I had that insurance once and I will never go back to it. Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)From: Jane Bigler <janemhar@...>To:

infantile scoliosis treatment Sent: Thu, January 20, 2011 4:19:08 PMSubject: Shriner's billing/Kaiser Insurance

Hi, just got our official denial from Kaiser to cover our services at Shriner's. Reason: there are no services the practioners at Kaiser cannot provide.

BS!!!

Had their providers been able to do any of what services Shriner's had provided, I wouldnt' have sought a second opinion through Shriner's in the first place! Has any one had any success getting through the appeal process with Kaiser??

Thanks!

Jane

[Guest guest]

Hi, I just started with Kaiser this year but i know that they woould not even let one of the mom bring her child to Loma here Southern California when only Loma linda has the Mehta trained doctor. I am still waiting for my appointment with the pediatric ortho. once i get to talk to this doctor i will ask if they can do the mehta casting and will share what to this group whateve this doctor has to say.

On the other hand is Shriners now charging? I know that last year they have a notice that they are applying for a third party payment meaning they will ask insurance to pay. We are scheduled to have cast adjustment on the 31st but i have not receive any notice or letter regarding charges.

Any info about this?

Ethelyn

From: NIck Guthe <nickguthe@...>Subject: Re: Shriner's billing/Kaiser Insuranceinfantile scoliosis treatment Date: Friday, January 21, 2011, 10:19 AM

BS! I so agree, Jane, I had that insurance once and I will never go back to it.

Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)

From: Jane Bigler <janemhar@...>infantile scoliosis treatment Sent: Thu, January 20, 2011 4:19:08 PMSubject: Shriner's billing/Kaiser Insurance

Hi, just got our official denial from Kaiser to cover our services at Shriner's. Reason: there are no services the practioners at Kaiser cannot provide.

BS!!!

Had their providers been able to do any of what services Shriner's had provided, I wouldnt' have sought a second opinion through Shriner's in the first place! Has any one had any success getting through the appeal process with Kaiser??

Thanks!

Jane

[Guest guest]

Hi Ethelyn, my understanding is they may bill your insurance if you have it, but you will never get a bill yourself no matter what as long as your child is treated within Shriners' walls. In other words, you won't be charged what your ins. won't pay. Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)From: ethelyn billones <Ethelyn_ph@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:22:22 AMSubject: Re: Shriner's billing/Kaiser Insurance

Hi, I just started with Kaiser this year but i know that they woould not even let one of the mom bring her child to Loma here Southern California when only Loma linda has the Mehta trained doctor. I am still waiting for my appointment with the pediatric ortho. once i get to talk to this doctor i will ask if they can do the mehta casting and will share what to this group whateve this doctor has to say.

On the other hand is Shriners now charging? I know that last year they have a notice that they are applying for a third party payment meaning they will ask insurance to pay. We are scheduled to have cast adjustment on the 31st but i have not receive any notice or letter regarding charges.

Any info about this?

Ethelyn

From: NIck Guthe <nickguthe@...>Subject: Re: Shriner's billing/Kaiser Insuranceinfantile scoliosis treatment Date: Friday, January 21, 2011, 10:19 AM

BS! I so agree, Jane, I had that insurance once and I will never go back to it.

Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)

From: Jane Bigler <janemhar@...>infantile scoliosis treatment Sent: Thu, January 20, 2011 4:19:08 PMSubject: Shriner's billing/Kaiser Insurance

Hi, just got our official denial from Kaiser to cover our services at Shriner's. Reason: there are no services the practioners at Kaiser cannot provide.

BS!!!

Had their providers been able to do any of what services Shriner's had provided, I wouldnt' have sought a second opinion through Shriner's in the first place! Has any one had any success getting through the appeal process with Kaiser??

Thanks!

Jane

[Guest guest]

Any idea how much time/effort/blood/sweat/tears they expect us to put into the appeal process tho? I currently have 3 appeals going with Kaiser already for things/services they have denied Grace thus far. I don't have any more fight to start this one, although I know Shriner's needs the money! And the whole thing pisses me off so much I feel like I'm going to explode! I just don't know if I can deal with another roller coaster.

Jane

From: NIck Guthe <nickguthe@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:45:45 PMSubject: Re: Shriner's billing/Kaiser Insurance

Hi Ethelyn, my understanding is they may bill your insurance if you have it, but you will never get a bill yourself no matter what as long as your child is treated within Shriners' walls. In other words, you won't be charged what your ins. won't pay.

Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)

From: ethelyn billones <Ethelyn_ph@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:22:22 AMSubject: Re: Shriner's billing/Kaiser Insurance

Hi, I just started with Kaiser this year but i know that they woould not even let one of the mom bring her child to Loma here Southern California when only Loma linda has the Mehta trained doctor. I am still waiting for my appointment with the pediatric ortho. once i get to talk to this doctor i will ask if they can do the mehta casting and will share what to this group whateve this doctor has to say.

On the other hand is Shriners now charging? I know that last year they have a notice that they are applying for a third party payment meaning they will ask insurance to pay. We are scheduled to have cast adjustment on the 31st but i have not receive any notice or letter regarding charges.

Any info about this?

Ethelyn

From: NIck Guthe <nickguthe@...>Subject: Re: Shriner's billing/Kaiser Insuranceinfantile scoliosis treatment Date: Friday, January 21, 2011, 10:19 AM

BS! I so agree, Jane, I had that insurance once and I will never go back to it.

Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)

From: Jane Bigler <janemhar@...>infantile scoliosis treatment Sent: Thu, January 20, 2011 4:19:08 PMSubject: Shriner's billing/Kaiser Insurance

Hi, just got our official denial from Kaiser to cover our services at Shriner's. Reason: there are no services the practioners at Kaiser cannot provide.

BS!!!

Had their providers been able to do any of what services Shriner's had provided, I wouldnt' have sought a second opinion through Shriner's in the first place! Has any one had any success getting through the appeal process with Kaiser??

Thanks!

Jane

[Guest guest]

Jane,All I know so far is that the lovely woman who took my insurance card again in SLC said "they'll probably never pay us anyway, but..."I don't think our Shriners is going to expect us to fight the ins. -based on our experience so far, anyway. We currently have a PPO plan through Blue Cross. I had bad experiences with HMOs in my 20's, that's why I don't trust HMOs. Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)From: Jane Bigler <janemhar@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:58:59 PMSubject: Re: Shriner's billing/Kaiser Insurance

Any idea how much time/effort/blood/sweat/tears they expect us to put into the appeal process tho? I currently have 3 appeals going with Kaiser already for things/services they have denied Grace thus far. I don't have any more fight to start this one, although I know Shriner's needs the money! And the whole thing pisses me off so much I feel like I'm going to explode! I just don't know if I can deal with another roller coaster.

Jane

From: NIck Guthe <nickguthe@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:45:45 PMSubject: Re: Shriner's billing/Kaiser Insurance

Hi Ethelyn, my understanding is they may bill your insurance if you have it, but you will never get a bill yourself no matter what as long as your child is treated within Shriners' walls. In other words, you won't be charged what your ins. won't pay.

Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)

From: ethelyn billones <Ethelyn_ph@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:22:22 AMSubject: Re: Shriner's billing/Kaiser Insurance

Hi, I just started with Kaiser this year but i know that they woould not even let one of the mom bring her child to Loma here Southern California when only Loma linda has the Mehta trained doctor. I am still waiting for my appointment with the pediatric ortho. once i get to talk to this doctor i will ask if they can do the mehta casting and will share what to this group whateve this doctor has to say.

On the other hand is Shriners now charging? I know that last year they have a notice that they are applying for a third party payment meaning they will ask insurance to pay. We are scheduled to have cast adjustment on the 31st but i have not receive any notice or letter regarding charges.

Any info about this?

Ethelyn

From: NIck Guthe <nickguthe@...>Subject: Re: Shriner's billing/Kaiser Insuranceinfantile scoliosis treatment Date: Friday, January 21, 2011, 10:19 AM

BS! I so agree, Jane, I had that insurance once and I will never go back to it.

Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)

From: Jane Bigler <janemhar@...>infantile scoliosis treatment Sent: Thu, January 20, 2011 4:19:08 PMSubject: Shriner's billing/Kaiser Insurance

Hi, just got our official denial from Kaiser to cover our services at Shriner's. Reason: there are no services the practioners at Kaiser cannot provide.

BS!!!

Had their providers been able to do any of what services Shriner's had provided, I wouldnt' have sought a second opinion through Shriner's in the first place! Has any one had any success getting through the appeal process with Kaiser??

Thanks!

Jane

[Guest guest]

Heidi,

My insurance had already denied them. Then they insisted that I have my pediatrician put in a referral to them as the first claim was denied based on lack of referral. Now they have denied the referral. Any idea if this is a one time thing or will it come with EVERY appt every time?

Jane

From: NIck Guthe <nickguthe@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 3:10:16 PMSubject: Re: Shriner's billing/Kaiser Insurance

Jane,All I know so far is that the lovely woman who took my insurance card again in SLC said "they'll probably never pay us anyway, but..."I don't think our Shriners is going to expect us to fight the ins. -based on our experience so far, anyway. We currently have a PPO plan through Blue Cross. I had bad experiences with HMOs in my 20's, that's why I don't trust HMOs.

Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)

From: Jane Bigler <janemhar@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:58:59 PMSubject: Re: Shriner's billing/Kaiser Insurance

Any idea how much time/effort/blood/sweat/tears they expect us to put into the appeal process tho? I currently have 3 appeals going with Kaiser already for things/services they have denied Grace thus far. I don't have any more fight to start this one, although I know Shriner's needs the money! And the whole thing pisses me off so much I feel like I'm going to explode! I just don't know if I can deal with another roller coaster.

Jane

From: NIck Guthe <nickguthe@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:45:45 PMSubject: Re: Shriner's billing/Kaiser Insurance

Hi Ethelyn, my understanding is they may bill your insurance if you have it, but you will never get a bill yourself no matter what as long as your child is treated within Shriners' walls. In other words, you won't be charged what your ins. won't pay.

Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)

From: ethelyn billones <Ethelyn_ph@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:22:22 AMSubject: Re: Shriner's billing/Kaiser Insurance

Hi, I just started with Kaiser this year but i know that they woould not even let one of the mom bring her child to Loma here Southern California when only Loma linda has the Mehta trained doctor. I am still waiting for my appointment with the pediatric ortho. once i get to talk to this doctor i will ask if they can do the mehta casting and will share what to this group whateve this doctor has to say.

On the other hand is Shriners now charging? I know that last year they have a notice that they are applying for a third party payment meaning they will ask insurance to pay. We are scheduled to have cast adjustment on the 31st but i have not receive any notice or letter regarding charges.

Any info about this?

Ethelyn

From: NIck Guthe <nickguthe@...>Subject: Re: Shriner's billing/Kaiser Insuranceinfantile scoliosis treatment Date: Friday, January 21, 2011, 10:19 AM

BS! I so agree, Jane, I had that insurance once and I will never go back to it.

Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)

From: Jane Bigler <janemhar@...>infantile scoliosis treatment Sent: Thu, January 20, 2011 4:19:08 PMSubject: Shriner's billing/Kaiser Insurance

Hi, just got our official denial from Kaiser to cover our services at Shriner's. Reason: there are no services the practioners at Kaiser cannot provide.

BS!!!

Had their providers been able to do any of what services Shriner's had provided, I wouldnt' have sought a second opinion through Shriner's in the first place! Has any one had any success getting through the appeal process with Kaiser??

Thanks!

Jane

[Guest guest]

Jane - that is the nature of Kaiser insurance - they don't want to pay anything outside their world - that is how they keep costs low. it does suck.We have Blue Cross PPO - Shriners billed for our last cast - they paid a little over $5600 to Shriners and told me I was responsible for $6600 - since I used an 'out of network' provider - I contacted Shriners and they said not to worry I didn't have to pay anything. I am glad they were able to get some $$ out of my insurance - since they haven't had to pay a penny for any of my daughter's scoli care.From: NIck Guthe <nickguthe@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 3:10:16 PMSubject: Re: Shriner's billing/Kaiser Insurance

Jane,All I know so far is that the lovely woman who took my insurance card again in SLC said "they'll probably never pay us anyway, but..."I don't think our Shriners is going to expect us to fight the ins. -based on our experience so far, anyway. We currently have a PPO plan through Blue Cross. I had bad experiences with HMOs in my 20's, that's why I don't trust HMOs. Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)From: Jane Bigler <janemhar@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:58:59 PMSubject: Re: Shriner's billing/Kaiser Insurance

Any idea how much time/effort/blood/sweat/tears they expect us to put into the appeal process tho? I currently have 3 appeals going with Kaiser already for things/services they have denied Grace thus far. I don't have any more fight to start this one, although I know Shriner's needs the money! And the whole thing pisses me off so much I feel like I'm going to explode! I just don't know if I can deal with another roller coaster.

Jane

From: NIck Guthe <nickguthe@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:45:45 PMSubject: Re: Shriner's billing/Kaiser Insurance

Hi Ethelyn, my understanding is they may bill your insurance if you have it, but you will never get a bill yourself no matter what as long as your child is treated within Shriners' walls. In other words, you won't be charged what your ins. won't pay.

Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)

From: ethelyn billones <Ethelyn_ph@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:22:22 AMSubject: Re: Shriner's billing/Kaiser Insurance

Hi, I just started with Kaiser this year but i know that they woould not even let one of the mom bring her child to Loma here Southern California when only Loma linda has the Mehta trained doctor. I am still waiting for my appointment with the pediatric ortho. once i get to talk to this doctor i will ask if they can do the mehta casting and will share what to this group whateve this doctor has to say.

On the other hand is Shriners now charging? I know that last year they have a notice that they are applying for a third party payment meaning they will ask insurance to pay. We are scheduled to have cast adjustment on the 31st but i have not receive any notice or letter regarding charges.

Any info about this?

Ethelyn

From: NIck Guthe <nickguthe@...>Subject: Re: Shriner's billing/Kaiser Insuranceinfantile scoliosis treatment Date: Friday, January 21, 2011, 10:19 AM

BS! I so agree, Jane, I had that insurance once and I will never go back to it.

Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com)

From: Jane Bigler <janemhar@...>infantile scoliosis treatment Sent: Thu, January 20, 2011 4:19:08 PMSubject: Shriner's billing/Kaiser Insurance

Hi, just got our official denial from Kaiser to cover our services at Shriner's. Reason: there are no services the practioners at Kaiser cannot provide.

BS!!!

Had their providers been able to do any of what services Shriner's had provided, I wouldnt' have sought a second opinion through Shriner's in the first place! Has any one had any success getting through the appeal process with Kaiser??

Thanks!

Jane

[Guest guest]

Jane,

I have no words to help with Kaiser, but I can tell you I've been where you are.

I have felt your anger and frustration.

Be sure to report these problems to your Human Resources representative. They

have input into choosing what services are covered by your plans, and they

should know the quality of service provided to their employees is not what it

should be.

Blessings and hugs,

Sherry

[Guest guest]

DITTO! From: infantile scoliosis treatment [mailto:infantile scoliosis treatment ] On Behalf Of NIck GutheSent: Thursday, January 20, 2011 7:20 PMinfantile scoliosis treatment Subject: Re: Shriner's billing/Kaiser Insurance BS! I so agree, Jane, I had that insurance once and I will never go back to it. Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com) From: Jane Bigler <janemhar@...>infantile scoliosis treatment Sent: Thu, January 20, 2011 4:19:08 PMSubject: Shriner's billing/Kaiser Insurance Hi, just got our official denial from Kaiser to cover our services at Shriner's. Reason: there are no services the practioners at Kaiser cannot provide. BS!!! Had their providers been able to do any of what services Shriner's had provided, I wouldnt' have sought a second opinion through Shriner's in the first place! Has any one had any success getting through the appeal process with Kaiser?? Thanks! Jane

[Guest guest]

All the blood , sweat & tears you have.  Its criminal really.  I mean, how can a mother do the best for her child when she is continually battling with the ins. providers who are trained to deny to save provider $.  Jane, I feel your pain and it makes me soooo angry.  I actually had to threaten them with media, lawsuit, etc…On top of the docs letter.Its simply WRONG.  Its not like your asking for something that is unnecessary.We are here to rally for you Jane!!Keep up the good fight!HRH From: infantile scoliosis treatment [mailto:infantile scoliosis treatment ] On Behalf Of Jane BiglerSent: Friday, January 21, 2011 3:59 PMinfantile scoliosis treatment Subject: Re: Shriner's billing/Kaiser Insurance Any idea how much time/effort/blood/sweat/tears they expect us to put into the appeal process tho? I currently have 3 appeals going with Kaiser already for things/services they have denied Grace thus far. I don't have any more fight to start this one, although I know Shriner's needs the money! And the whole thing pisses me off so much I feel like I'm going to explode! I just don't know if I can deal with another roller coaster. Jane From: NIck Guthe <nickguthe@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:45:45 PMSubject: Re: Shriner's billing/Kaiser Insurance Hi Ethelyn, my understanding is they may bill your insurance if you have it, but you will never get a bill yourself no matter what as long as your child is treated within Shriners' walls. In other words, you won't be charged what your ins. won't pay. Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com) From: ethelyn billones <Ethelyn_ph@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:22:22 AMSubject: Re: Shriner's billing/Kaiser Insurance Hi, I just started with Kaiser this year but i know that they woould not even let one of the mom bring her child to Loma here Southern California when only Loma linda has the Mehta trained doctor. I am still waiting for my appointment with the pediatric ortho. once i get to talk to this doctor i will ask if they can do the mehta casting and will share what to this group whateve this doctor has to say. On the other hand is Shriners now charging? I know that last year they have a notice that they are applying for a third party payment meaning they will ask insurance to pay. We are scheduled to have cast adjustment on the 31st but i have not receive any notice or letter regarding charges. Any info about this? EthelynFrom: NIck Guthe <nickguthe@...>Subject: Re: Shriner's billing/Kaiser Insuranceinfantile scoliosis treatment Date: Friday, January 21, 2011, 10:19 AM BS! I so agree, Jane, I had that insurance once and I will never go back to it. Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com) From: Jane Bigler <janemhar@...>infantile scoliosis treatment Sent: Thu, January 20, 2011 4:19:08 PMSubject: Shriner's billing/Kaiser Insurance Hi, just got our official denial from Kaiser to cover our services at Shriner's. Reason: there are no services the practioners at Kaiser cannot provide. BS!!! Had their providers been able to do any of what services Shriner's had provided, I wouldnt' have sought a second opinion through Shriner's in the first place! Has any one had any success getting through the appeal process with Kaiser?? Thanks! Jane

[Guest guest]

$13,000 per cast.  That’s great!  Some docs applying ET are getting reimbursed only $36.00  Go Shriners!HRH From: infantile scoliosis treatment [mailto:infantile scoliosis treatment ] On Behalf Of Sonja EggerSent: Friday, January 21, 2011 10:42 PMinfantile scoliosis treatment Subject: Re: Shriner's billing/Kaiser Insurance Our Blue Cross/Blue Shield sent us two checks made out to us total for $26,000 that we are to give to Shriner's and that is for 2 casts! So insurance does pay if it is billed correctly- just so fortunate for Shriner's and how amazing they are and for great insurance! From: NIck Guthe <nickguthe@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 3:10:16 PMSubject: Re: Shriner's billing/Kaiser Insurance Jane,All I know so far is that the lovely woman who took my insurance card again in SLC said " they'll probably never pay us anyway, but... " I don't think our Shriners is going to expect us to fight the ins. -based on our experience so far, anyway. We currently have a PPO plan through Blue Cross. I had bad experiences with HMOs in my 20's, that's why I don't trust HMOs. Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com) From: Jane Bigler <janemhar@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:58:59 PMSubject: Re: Shriner's billing/Kaiser Insurance Any idea how much time/effort/blood/sweat/tears they expect us to put into the appeal process tho? I currently have 3 appeals going with Kaiser already for things/services they have denied Grace thus far. I don't have any more fight to start this one, although I know Shriner's needs the money! And the whole thing pisses me off so much I feel like I'm going to explode! I just don't know if I can deal with another roller coaster. Jane From: NIck Guthe <nickguthe@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:45:45 PMSubject: Re: Shriner's billing/Kaiser Insurance Hi Ethelyn, my understanding is they may bill your insurance if you have it, but you will never get a bill yourself no matter what as long as your child is treated within Shriners' walls. In other words, you won't be charged what your ins. won't pay. Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com) From: ethelyn billones <Ethelyn_ph@...>infantile scoliosis treatment Sent: Fri, January 21, 2011 2:22:22 AMSubject: Re: Shriner's billing/Kaiser Insurance Hi, I just started with Kaiser this year but i know that they woould not even let one of the mom bring her child to Loma here Southern California when only Loma linda has the Mehta trained doctor. I am still waiting for my appointment with the pediatric ortho. once i get to talk to this doctor i will ask if they can do the mehta casting and will share what to this group whateve this doctor has to say. On the other hand is Shriners now charging? I know that last year they have a notice that they are applying for a third party payment meaning they will ask insurance to pay. We are scheduled to have cast adjustment on the 31st but i have not receive any notice or letter regarding charges. Any info about this? EthelynFrom: NIck Guthe <nickguthe@...>Subject: Re: Shriner's billing/Kaiser Insuranceinfantile scoliosis treatment Date: Friday, January 21, 2011, 10:19 AM BS! I so agree, Jane, I had that insurance once and I will never go back to it. Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's Story on www.GirltoMom.com) From: Jane Bigler <janemhar@...>infantile scoliosis treatment Sent: Thu, January 20, 2011 4:19:08 PMSubject: Shriner's billing/Kaiser Insurance Hi, just got our official denial from Kaiser to cover our services at Shriner's. Reason: there are no services the practioners at Kaiser cannot provide. BS!!! Had their providers been able to do any of what services Shriner's had provided, I wouldnt' have sought a second opinion through Shriner's in the first place! Has any one had any success getting through the appeal process with Kaiser?? Thanks! Jane

[Guest guest]

I can believe that ($36 per cast). I saw the EOB for one of 's

recent follow-up visits. Can't recall the exact amount that was billed to our

insurance carrier (Multiplan), but that day saw Dr. B and had an x-ray as

well. The payment by Multiplan to Shriners was a VERY small fraction of the

amount billed. But I guess every little bit helps - and hopefully some

insurance carriers are a bit more generous!

>

>

> From: NIck Guthe <nickguthe@...>

> Subject: Re: Shriner's billing/Kaiser Insurance

> infantile scoliosis treatment

> Date: Friday, January 21, 2011, 10:19 AM

>

>

>

> BS! I so agree, Jane, I had that insurance once and I will never go back to

it.

>

>

>

> Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City

Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's

Story on www.GirltoMom.com <http://www.girltomom.com/> )

>

>

>

>

>

>

> _____

>

>

> From: Jane Bigler <janemhar@...>

> infantile scoliosis treatment

> Sent: Thu, January 20, 2011 4:19:08 PM

> Subject: Shriner's billing/Kaiser Insurance

>

>

>

> Hi, just got our official denial from Kaiser to cover our services at

Shriner's. Reason: there are no services the practioners at Kaiser cannot

provide.

>

>

>

> BS!!!

>

>

>

> Had their providers been able to do any of what services Shriner's had

provided, I wouldnt' have sought a second opinion through Shriner's in the first

place! Has any one had any success getting through the appeal process with

Kaiser??

>

>

>

> Thanks!

>

>

> Jane

>

[Guest guest]

You are so right, , when you say 'it's not like we are asking for

something that is unnecessary'. Do these insurance companies think we are

putting our kids in casts and braces just for the fun of it??!! Makes me so

angry as well. And, yes, if even one child misses the window where they can be

helped and their spine can be straightened, somebody's a** belongs in jail

because it certainly IS criminal!

>

>

> From: NIck Guthe <nickguthe@...>

> Subject: Re: Shriner's billing/Kaiser Insurance

> infantile scoliosis treatment

> Date: Friday, January 21, 2011, 10:19 AM

>

>

>

> BS! I so agree, Jane, I had that insurance once and I will never go back to

it.

>

>

>

> Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City

Shriners, currently down from 63 degrees to 14.6 in cast. You can read Bexon's

Story on www.GirltoMom.com <http://www.girltomom.com/> )

>

>

>

>

>

>

> _____

>

>

> From: Jane Bigler <janemhar@...>

> infantile scoliosis treatment

> Sent: Thu, January 20, 2011 4:19:08 PM

> Subject: Shriner's billing/Kaiser Insurance

>

>

>

> Hi, just got our official denial from Kaiser to cover our services at

Shriner's. Reason: there are no services the practioners at Kaiser cannot

provide.

>

>

>

> BS!!!

>

>

>

> Had their providers been able to do any of what services Shriner's had

provided, I wouldnt' have sought a second opinion through Shriner's in the first

place! Has any one had any success getting through the appeal process with

Kaiser??

>

>

>

> Thanks!

>

>

> Jane

>

[Guest guest]

Yes, Shriners will treat the child regardless of whether or not insurance will

cover their services.

I didn't know much about Kaiser before, but I am really hating them right about

now.

> >

> > Hi, just got our official denial from Kaiser to cover our services at

> > Shriner's.  Reason: there are no services the practioners at Kaiser cannot

> > provide.

> >

> > BS!!!

> >

> > Had their providers been able to do any of what services Shriner's had

provided,

> > I wouldnt' have sought a second opinion through Shriner's in the first

place! 

> > Has any one had any success getting through the appeal process with Kaiser??

> >

> > Thanks!

> >  

> > Jane

> >

>

[Guest guest]

Sorry if this sound cold, but it WOULD serve them right. That story is

unbelievable, Suzy. Or perhaps, sadly, it's not that hard to believe when you

have been dealing with insurance companies long enough. Like I said in my other

post, when a child is denied a much-needed service by their insurance carrier -

and that child suffers for it - somebody's a** belongs in jail because it is

truly criminal.

> >

> >

> > From: NIck Guthe <nickguthe@>

> > Subject: Re: Shriner's billing/Kaiser Insurance

> > _infantile scoliosis treatment _

> (mailto:infantile scoliosis treatment )

> > Date: Friday, January 21, 2011, 10:19 AM

> >

> >

> >

> > BS! I so agree, Jane, I had that insurance once and I will never go back

> to it.

> >

> >

> >

> > Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City

> Shriners, currently down from 63 degrees to 14.6 in cast. You can read

> Bexon's Story on www.GirltoMom.com <_http://www.girltomom.com/_

> (http://www.girltomom.com/) > )

> >

> >

> >

> >

> >

> >

> > _____

> >

> >

> > From: Jane Bigler <janemhar@>

> > _infantile scoliosis treatment _

> (mailto:infantile scoliosis treatment )

> > Sent: Thu, January 20, 2011 4:19:08 PM

> > Subject: Shriner's billing/Kaiser Insurance

> >

> >

> >

> > Hi, just got our official denial from Kaiser to cover our services at

> Shriner's. Reason: there are no services the practioners at Kaiser cannot

> provide.

> >

> >

> >

> > BS!!!

> >

> >

> >

> > Had their providers been able to do any of what services Shriner's had

> provided, I wouldnt' have sought a second opinion through Shriner's in the

> first place! Has any one had any success getting through the appeal process

> with Kaiser??

> >

> >

> >

> > Thanks!

> >

> >

> > Jane

> >

>

[Guest guest]

Hey Heidi,

Not sure if it will help, but I'll reach out to the PR folks in Philly. They

are actually the people I work most closely with - and Terry Diamond (who used

to head PR for the northeast and now runs the Development department for that

same region for Shriners) knows all the folks in Tampa.

Can't hurt, right? Maybe they just need a 'nudge' internally :-)

> > >

> > >

> > > >From: NIck Guthe <nickguthe@>

> > > >Subject: Re: Shriner's billing/Kaiser Insurance

> > > >infantile scoliosis treatment

> > > >Date: Friday, January 21, 2011, 10:19 AM

> > > >

> > > >

> > > >Â

> > > >BS! I so agree, Jane, I had that insurance once and I will never go back

to

>

> > >it.

> > >

> > >

> > > >

> > > >Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City

> > >Shriners,

> > >

> > > >currently down from 63 degrees to 14.6 in cast. You can read Bexon's

Story

> >on

> >

> >

> > > >www.GirltoMom.com)

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > ________________________________

> > > From: Jane Bigler <janemhar@>

> > > >infantile scoliosis treatment

> > > >Sent: Thu, January 20, 2011 4:19:08 PM

> > > >Subject: Shriner's billing/Kaiser Insurance

> > > >

> > > >Â

> > > >Hi, just got our official denial from Kaiser to cover our services at

> > > >Shriner's. Reason: there are no services the practioners at

Kaiser

> >cannot

> >

> > > >provide.

> > > >

> > > >BS!!!

> > > >

> > > >Had their providers been able to do any of what services Shriner's

had

> > >provided,

> > >

> > > >I wouldnt' have sought a second opinion through Shriner's in the first

> > >place!Â

> > >

> > > >Has any one had any success getting through the appeal process with

> >Kaiser??

> > > >

> > > >Thanks!

> > > >Â

> > > >Jane

> > > >

> > > >

> > > >

> > > >

> > >

> >

>

[Guest guest]

Hey Heidi,

Not sure if it will help, but I'll reach out to the PR folks in Philly. They

are actually the people I work most closely with - and Terry Diamond (who used

to head PR for the northeast and now runs the Development department for that

same region for Shriners) knows all the folks in Tampa.

Can't hurt, right? Maybe they just need a 'nudge' internally :-)

> > >

> > >

> > > >From: NIck Guthe <nickguthe@>

> > > >Subject: Re: Shriner's billing/Kaiser Insurance

> > > >infantile scoliosis treatment

> > > >Date: Friday, January 21, 2011, 10:19 AM

> > > >

> > > >

> > > >Â

> > > >BS! I so agree, Jane, I had that insurance once and I will never go back

to

>

> > >it.

> > >

> > >

> > > >

> > > >Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City

> > >Shriners,

> > >

> > > >currently down from 63 degrees to 14.6 in cast. You can read Bexon's

Story

> >on

> >

> >

> > > >www.GirltoMom.com)

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > ________________________________

> > > From: Jane Bigler <janemhar@>

> > > >infantile scoliosis treatment

> > > >Sent: Thu, January 20, 2011 4:19:08 PM

> > > >Subject: Shriner's billing/Kaiser Insurance

> > > >

> > > >Â

> > > >Hi, just got our official denial from Kaiser to cover our services at

> > > >Shriner's. Reason: there are no services the practioners at

Kaiser

> >cannot

> >

> > > >provide.

> > > >

> > > >BS!!!

> > > >

> > > >Had their providers been able to do any of what services Shriner's

had

> > >provided,

> > >

> > > >I wouldnt' have sought a second opinion through Shriner's in the first

> > >place!Â

> > >

> > > >Has any one had any success getting through the appeal process with

> >Kaiser??

> > > >

> > > >Thanks!

> > > >Â

> > > >Jane

> > > >

> > > >

> > > >

> > > >

> > >

> >

>

[Guest guest]

Hi Heidi,

I haven't forgotten about this. My friend in Philly was out of the office a day

or two because of (more) snow here in the northeast, but she has now put out

some feelers and will get back to me one way or the other. I'll keep you

posted.

> > > >

> > > >

> > > > >From: NIck Guthe <nickguthe@>

> > > > >Subject: Re: Shriner's billing/Kaiser Insurance

> > > > >infantile scoliosis treatment

> > > > >Date: Friday, January 21, 2011, 10:19 AM

> > > > >

> > > > >

> > > > >ÃÆ'‚

> > > > >BS! I so agree, Jane, I had that insurance once and I will never go

back

> >to

> >

> >

> > > >it.

> > > >

> > > >

> > > > >

> > > > >Heidi, Bexon's Mommy, (3.5 years old, in 9th cast from Salt Lake City

> > > >Shriners,

> > > >

> > > > >currently down from 63 degrees to 14.6 in cast. You can read Bexon's

Story

> >

> > >on

> > >

> > >

> > > > >www.GirltoMom.com)

> > > > >

> > > > >

> > > > >

> > > > >

> > > > >

> > > > >

> > > > ________________________________

> > > > From: Jane Bigler <janemhar@>

> > > > >infantile scoliosis treatment

> > > > >Sent: Thu, January 20, 2011 4:19:08 PM

> > > > >Subject: Shriner's billing/Kaiser Insurance

> > > > >

> > > > >ÃÆ'‚

> > > > >Hi, just got our official denial from Kaiser to cover our services at

> > > > >Shriner's.ÃÆ'‚ Reason: there are no servicesÃÆ'‚ the

practioners at

> >Kaiser

> >

> > >cannot

> > >

> > > > >provide.

> > > > >

> > > > >BS!!!

> > > > >

> > > > >Had their providers been able to do any of what servicesÃÆ'‚

Shriner's

> >had

> >

> > > >provided,

> > > >

> > > > >I wouldnt' have sought a second opinion through Shriner's in the first

> > > >place!ÃÆ'‚

> > > >

> > > > >Has any one had any success getting through the appealÃÆ'‚

process with

> > >Kaiser??

> > > > >

> > > > >Thanks!

> > > > >ÃÆ'‚

> > > > >Jane

> > > > >

> > > > >

> > > > >

> > > > >

> > > >

> > >

> >

>