Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Hang in there , it will all work out eventually. Whatever you do, don't give up. Fight with every ounce of strength you can muster, and don't worry about being too kind about it. As far as your insurance, aren't they responsible by law to cover you as you were diagnosed to need the surgery while insured by them??? I would make a few phone calls to your local Representatives or state health agencies as they will know whether you have to be covered or not. I do know these bastards (forgive the term, but I was always taught to call a ball a ball, a strike a strike and so on & so forth!!) are heavily regulated by law, but that varies from state to state. It is worth a phone call. These agencies usually have a toll free # to call so it won't even cost you to make it. Let me know how you make out, Kirk. PS....I can see no reason why you'd be denied SSDI, knowing quite a bit about your situation. As I've found out most who deserve it get it, although they tend to like to make some fight for it to justify their jobs at times. Adios! 2008/6/1 Christenson : > Hi Everyone, > > I wanted to let you all know that my Hysterectomy scheduled for Tuesday has > been canceled because of insurance issues. > > My currant HMO is droping it's Aged, Blind, and Disabled(ABD) Coverage as > of July 1st. My OBGYN (who was going to do my surgery) is not a member > doctor for my currant insurance. 3months ago I spent 1month trying to get my > insurance to authorize my OBGYN so I could continue to see a doctor who had > some clue about what was happening to me and how my body works. Well I got > the insurance to authorize my OBGYN to be covered. I have had 2 office > consultations. One in April and One May 6th. My Doctor has been payed for > both visits. When my Doctor's office called to pre-cert my surgery the > insurance company told them that my OBGYN was not authorized to treat me, > and that they would not pay for her services for the surgery. When I called > my case manager at the insurance company (the same case manager that had > helpped me get my OBGYN authorized) tells me she(referring to my OBGYN) is > not authorized and has never been. So I called my OBGYN back to see if they > ever got payed for my > visits? My Insurance payed for my visits to my OBGYN, and now has > conveniently lost the authorization code for my OBGYN so that they don't > have to pay for an expensive surgery the last month they are going to cover > me because they are dropping ABD coverage. > > My Social Security Hearing is July 7th. I am postponing re-scheduling my > surgery until after the hearing. Please pray that I am declared disabled and > that I can then go through with my Hysterectomy. > > Everyone Take Care and thanks for all the thoughts and prayers! > > Fayette, OH > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 , My Dad broke both ankles the first of the year and needed surgery on one. His medical insurance company refused to pay a large part of the bills. My Dad's doctor was upset when hearing this, so he wrote a letter to the Attorney General. The following week my Mom got a call from the insurance company's customer response rep. and she said he was so nice it was like they were old friends. Anyway the insurance company paid every penny of doctor bills. You might want to see if your doctor can help you in that regard. Hope you start to feel better. Good luck, Brett No Surgery Tuesday Recent Activity a.. 3New Members b.. 15New Photos c.. 1New Files Visit Your Group Meditation and Lovingkindness A Yahoo! Group to share and learn. Yahoo! Health Heartburn or Worse What symptoms are most serious? Drive Traffic Sponsored Search can help increase your site traffic. . Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 , My Dad broke both ankles the first of the year and needed surgery on one. His medical insurance company refused to pay a large part of the bills. My Dad's doctor was upset when hearing this, so he wrote a letter to the Attorney General. The following week my Mom got a call from the insurance company's customer response rep. and she said he was so nice it was like they were old friends. Anyway the insurance company paid every penny of doctor bills. You might want to see if your doctor can help you in that regard. Hope you start to feel better. Good luck, Brett No Surgery Tuesday Recent Activity a.. 3New Members b.. 15New Photos c.. 1New Files Visit Your Group Meditation and Lovingkindness A Yahoo! Group to share and learn. Yahoo! Health Heartburn or Worse What symptoms are most serious? Drive Traffic Sponsored Search can help increase your site traffic. . Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Sorry , just for all your strugles. I'm new & in Ohio just let me know if there's a phone call I can make in your behalf & to to point what should be said,since I'm not familiar wt. what's going on untill this e- mail. Is the Dr. that diagnosed you in Columbus?. I'm waiting to see new Rheumy on the 25th. VIVI **************Get trade secrets for amazing burgers. Watch " Cooking with Tyler Florence " on AOL Food. (http://food.aol.com/tyler-florence?video=4 & ?NCID=aolfod00030000000002) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 OMG I am so sorry. This is not fair. You hang on my prayers are with you. Dumb insurance companies. Your Drs office obgyn where they paid should have a copy of the code on a fax sent from them try that if that helps at all. Email me if you need to vent sister Ann Fultz No Surgery Tuesday Hi Everyone, I wanted to let you all know that my Hysterectomy scheduled for Tuesday has been canceled because of insurance issues. My currant HMO is droping it's Aged, Blind, and Disabled(ABD) Coverage as of July 1st. My OBGYN (who was going to do my surgery) is not a member doctor for my currant insurance. 3months ago I spent 1month trying to get my insurance to authorize my OBGYN so I could continue to see a doctor who had some clue about what was happening to me and how my body works. Well I got the insurance to authorize my OBGYN to be covered. I have had 2 office consultations. One in April and One May 6th. My Doctor has been payed for both visits. When my Doctor's office called to pre-cert my surgery the insurance company told them that my OBGYN was not authorized to treat me, and that they would not pay for her services for the surgery. When I called my case manager at the insurance company (the same case manager that had helpped me get my OBGYN authorized) tells me she(referring to my OBGYN) is not authorized and has never been. So I called my OBGYN back to see if they ever got payed for my visits? My Insurance payed for my visits to my OBGYN, and now has conveniently lost the authorization code for my OBGYN so that they don't have to pay for an expensive surgery the last month they are going to cover me because they are dropping ABD coverage. My Social Security Hearing is July 7th. I am postponing re-scheduling my surgery until after the hearing. Please pray that I am declared disabled and that I can then go through with my Hysterectomy. Everyone Take Care and thanks for all the thoughts and prayers! Fayette, OH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 Thanks for the encouraging words. I wanted to let you know that the first thing I did after learning what was going on, I had my mom call the head of Job and Family Services in my county. My mom works with the head of Job and Family services and we have typed up my story and he has taken it and testified in front of the State Representatives. Anyway he is unable to help me. Since I don't have documented evidence that the insurance company has illegally denied me. My OBGYN was never one of Buckeye Community Health Insurance doctor's. I had to get special approval to see my OBGYN. My insurance company never sent me a letter with the approval authorization on it like they were supposed to. My Doctor won't take and push the matter because without documented evidence on our part of the authorization code if we took this to court more than likely it would go in favor of the insurance and they then could insist my Doctor pay them back for the office calls. They could claim that my OBGYN was never authorized and should have never been payed. Buckeye Community Health insurance covered their butts, and have made it impossible for me to challenge their ruling. I will be calling my Representative on Monday. As my Representative was my boss when my symptoms started he knows what I am going through and believes me when I tell him what is going on. Don't worry I will make sure that Ohio changes it's policy in regards to forcing Medicaid recipients in choosing an HMO for coverage. And right now HMO's are not regulated on when they enter and offer coverage and the leave and quit offering coverage. Don't worry I have the Fulton County Head of Job and Family Services calling reps on Monday and I will too. Things will change in OHIO. I am just sick of being the one who constantly gets screwed and has to be the one to fight for change to make sure that no one else suffers like I have. I have played this role my entire life, and I am getting very tired off it. I would like for once to not be the one who has to pave a new direction and make things better. Ok so I needed to blow off steam and right now I am still mad at the insurance company. Again Thanks for your caring words and trying to help me out. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2008 Report Share Posted June 1, 2008 : I know I have to get a new referral every few visits . this works out to about two times a year for my rummy. now in her office we have to get it and make sure it is up to date or we get billed thanks to you it may be a good idea as then we should know if it was done or not but if it runs out or it did not happen then we have to pay the bill any way as there policy is it is our responsibility. so here is a thought. if your doc dose not have one then the rummy should have some thing some were be it a auth number or some thing you could ask them for it and not for them to get in the middle. any thing you can get that shows they have paid and if it is for more then one visit would be better I think. this would show that even with out the origin letter the intent was there and that in there own accounting and paying the bills they had as a matter of infacto given the approval like i said just a thought the rednecks Marty & G. “Some men rob you with a six-gun - others with a fountain pen.” 7 days with out Jesus makes one weak Before giving someone a piece of mind be sure you have enough to spare! Buy a gun support the constitution and Piss off the liberals Gun control is a steady hand. Fight Socialism...Vote Republican we outlaw guns, only outlaws will have guns. Stills ; An illness I know to well! To learn about Stills http://www.stillsdisease.org/stills_info ----- Quote Link to comment Share on other sites More sharing options...
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