omg... insurance screw-up/need to gripe

December 10, 2004

AHHHHHHHHHHHHHHHHHHHHHHH.......... I am so angry and frustrated

right now and just need to scream! I HATE INSURANCE COMPANIES!!! To

make a long story short, i submitted my appeal at the beginning of

Nov. It was signed for in MD on Nov. 9th. Somehow my appeal made

it to Washington, DC to the claims dept. and my appeal was processed

as a claim. So i received a letter in the mail stating that my

claim was denied because i've already reached my 1k DME limit for

the year. Which, i hadn't even had ANY DME for this year, so speak

with someone, they don't understand why it says that, she'll get it

fixed, also, dosn't show anywhere in our file that our appeal is

there. She works on our case and after a few days figures out our

appeal was processed as a claim, etc... so she's going to work on

that for us and fix the DME issue. So i call monday, guess what,

our appeals been approved for 1k DME as out of network. Yippie, so

i'm happy. I asked what i'd have to do to get it covered in network

and member service says to contact utliziation dept., they say

contact some other dept, that dept. says contact members service.

Ehh.. so back to the start. I'm told not to cash my check until i

re-appeal for in network coverage and to send the check in with teh

2nd appeal. Anyway, come wednesday the woman above who was working

on our case calls and says that she's corrected the DME issue and

the check is in the mail and that my appeal was still in

processing. I told her i was told it'd already been approved, etc..

and she said no, it hadn't, blah blah. SOOO, I speak with someone

else who confirms that my appeal is still in processing, i should

hear word by friday. Todays friday, i'm all confused, my appeal

dosn't have an answer, i called again to see if i should then cash

this check or not and i'm told it's ok, i have that coming in

writing. I should have an answer now by thursday. The person i

spoke with today also got in touch with the appeals dept. to make

sure they understood that i am still seeking the other 2k for the

band. I'm just so darn frustrated. Had that one idiot who opened my

appeal, which starts " I AM APPEALING BECAUSE... " this would never

have happened and deserves a bb shot in the butt. Though the person

in claims who took the appeal as a claim should be shot too. Can

you believe all this.. I'm so frustrated! They should have no

choice but to cover it from all their mistakes!

Sorry all, i just needed to gripe. Thanks for listening! I'm on

the phone with insurance just about everyday. This is such a pain...

& 9 months, D0C Band 11/17 (brachy/mild tort)

Ashburn,VA

December 10, 2004

Oh gosh , how incredibly frustrating! I share your hate for

having to work w/these stupid insurance companies! I hope your

determination and patience pays off.

, mom to Hannah, DOCgrad

Cape Cod, Ma

>

> AHHHHHHHHHHHHHHHHHHHHHHH.......... I am so angry and frustrated

> right now and just need to scream! I HATE INSURANCE COMPANIES!!!

To

> make a long story short, i submitted my appeal at the beginning of

> Nov. It was signed for in MD on Nov. 9th. Somehow my appeal made

> it to Washington, DC to the claims dept. and my appeal was

processed

> as a claim. So i received a letter in the mail stating that my

> claim was denied because i've already reached my 1k DME limit for

> the year. Which, i hadn't even had ANY DME for this year, so

speak

> with someone, they don't understand why it says that, she'll get

it

> fixed, also, dosn't show anywhere in our file that our appeal is

> there. She works on our case and after a few days figures out our

> appeal was processed as a claim, etc... so she's going to work on

> that for us and fix the DME issue. So i call monday, guess what,

> our appeals been approved for 1k DME as out of network. Yippie,

so

> i'm happy. I asked what i'd have to do to get it covered in

network

> and member service says to contact utliziation dept., they say

> contact some other dept, that dept. says contact members service.

> Ehh.. so back to the start. I'm told not to cash my check until i

> re-appeal for in network coverage and to send the check in with

teh

> 2nd appeal. Anyway, come wednesday the woman above who was

working

> on our case calls and says that she's corrected the DME issue and

> the check is in the mail and that my appeal was still in

> processing. I told her i was told it'd already been approved,

etc..

> and she said no, it hadn't, blah blah. SOOO, I speak with someone

> else who confirms that my appeal is still in processing, i should

> hear word by friday. Todays friday, i'm all confused, my appeal

> dosn't have an answer, i called again to see if i should then cash

> this check or not and i'm told it's ok, i have that coming in

> writing. I should have an answer now by thursday. The person i

> spoke with today also got in touch with the appeals dept. to make

> sure they understood that i am still seeking the other 2k for the

> band. I'm just so darn frustrated. Had that one idiot who opened

my

> appeal, which starts " I AM APPEALING BECAUSE... " this would never

> have happened and deserves a bb shot in the butt. Though the

person

> in claims who took the appeal as a claim should be shot too. Can

> you believe all this.. I'm so frustrated! They should have no

> choice but to cover it from all their mistakes!

>

> Sorry all, i just needed to gripe. Thanks for listening! I'm on

> the phone with insurance just about everyday. This is such a

pain...

>

> & 9 months, D0C Band 11/17 (brachy/mild tort)

> Ashburn,VA

December 10, 2004

Whata HUGE pain in the heiny. So uncalled for. This is stressfukl

enough without the ins. crap. Good luck to you. STAY STRONG!!! You

can DO IT!!

Sue

Colin F., 14 mos.

STARband grad

>