Guest guest Posted February 23, 2003 Report Share Posted February 23, 2003 Mitzi, You need to talk to Tucker at MAGIC. She is the insurance guru. Does your insurance company have a case manager assigned to you? You should try to get one because that person would be the one to help you manage your insurance coverage. It would give you one contact who can then track down all the necessary people and departments to get the bills paid. At one point we had to do that and it helped tremendously. Call on Monday. She will know all the tricks of the trade. Jodi Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 27, 2004 Report Share Posted May 27, 2004 Stay away from Cigna...nothing but trouble!! Insurance question I was thinking of checking on prices of insurance; other then Medicare and Medicaid. Is there a consensus of what insurance company is the best for coverage of EDS over a long period of time? Any heads up on whom to steer clear of in the US? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 27, 2004 Report Share Posted May 27, 2004 Stay away from Cigna...nothing but trouble!! Insurance question I was thinking of checking on prices of insurance; other then Medicare and Medicaid. Is there a consensus of what insurance company is the best for coverage of EDS over a long period of time? Any heads up on whom to steer clear of in the US? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 27, 2004 Report Share Posted May 27, 2004 Thanks Bonnie; Good to know. It looks like I need to put on my thinking cap. I looked at this url http://www.pricingcentral.com/finance/health.htm And it talks about HMOS, PPOs, MediGap; and something about you can only use some doctors and hospitals but not all? Sigh; all I want is a price for some different insurances and what I can know it will cover. There is a senior citizen place near here that talks about insurances; I guess I will make an appt. Thanks again On 5/27/04 7:34 PM, " ceda " ceda > wrote: > > Subject: Re: Insurance question > > Stay away from Cigna...nothing but trouble!! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 28, 2004 Report Share Posted May 28, 2004 I agree -- Cigna is terrible!!!!!! I have had Blue Cross Blue Shield for the last four years, and they have been great. Hope this helps. Patti Insurance question I was thinking of checking on prices of insurance; other then Medicare and Medicaid. Is there a consensus of what insurance company is the best for coverage of EDS over a long period of time? Any heads up on whom to steer clear of in the US? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2004 Report Share Posted November 10, 2004 Before we started treating with Dr. Herzenberg I contacted Cigna to find out if there would be any coverage at all because he is in another state. Anyway, they assured me that we were participants in the " Seamless " plan (meaning we can treat with doctors outside of New Jersey). Also, she stated that Dr. Herzeberg was " In Network " for Cigna and we could go ahead and make our appointment because there is no problem. I was so relieved when she said that. So, on August 20th we started going to land and not worrying about it at all. Today, Dr. Herzenberg's billing office called and said Cigna kicked back almost every bill they have submitted. When I called Cigna the story changed. They said that Dr. Herzenberg is being paid by utilizing our " Out of Network " benefits because although Dr. Herzenberg is " In Network " with Cigna he is not in the " Seamless " plan. I explained that I spoke to a rep at Cigna and was assured there would be no issues with this at all! Is it me? Does this just not makes sense to me? If Dr. Herzenberg is " In Network " and I am in the " Seamless " plan shouldn't I have complete coverage? Has anyone had such a problem? Mommy to (12-17-98) and Christian (1-30-04) LCF - DBB 23/7 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2004 Report Share Posted November 10, 2004 Insurance companies make their money by charging premiums for services that will never be used and they do their best to see that that is what happens! Did you happen to write down the name of the rep that you spoke with? I would suggest writing them a detailed letter giving the date that you called and spoke to their rep. It may take a while to get it resolved but make sure that everything is in writing. For everyone else who will ever have to speak to a rep over the phone, always get a name and always follow up with a letter (or email) back to that person stating what you understand from the phone conversation, ie., " further to our telephone conversation this morning with regard to ____________, I understand that ABC insurance will cover costs for out of state medical treatment with Dr. Blank ...... " . Make it as detailed as you can so that there is no room for creative interpretation on their end. This way, you have a started a paper trail and will have something to back you up should your claim ever be denied. Daiga > > > Before we started treating with Dr. Herzenberg I contacted Cigna to find out > if there would be any coverage at all because he is in another state. > Anyway, they assured me that we were participants in the " Seamless " plan > (meaning we can treat with doctors outside of New Jersey). Also, she stated > that Dr. Herzeberg was " In Network " for Cigna and we could go ahead and make > our appointment because there is no problem. I was so relieved when she > said that. So, on August 20th we started going to land and not worrying > about it at all. Today, Dr. Herzenberg's billing office called and said > Cigna kicked back almost every bill they have submitted. When I called > Cigna the story changed. They said that Dr. Herzenberg is being paid by > utilizing our " Out of Network " benefits because although Dr. Herzenberg is > " In Network " with Cigna he is not in the " Seamless " plan. I explained that > I spoke to a rep at Cigna and was assured there would be no issues with this > at all! Is it me? Does this just not makes sense to me? If Dr. Herzenberg > is " In Network " and I am in the " Seamless " plan shouldn't I have complete > coverage? Has anyone had such a problem? > > > > > > > > Mommy to (12-17-98) and > > Christian (1-30-04) LCF - DBB 23/7 > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2004 Report Share Posted November 10, 2004 Don't they tape all the phone calls now anyway? I'm sure there's a record of it somewhere. Good advice though Daiga - thank you! Kori At 08:21 PM 11/10/2004, you wrote: >Insurance companies make their money by charging premiums for >services that will never be used and they do their best to see that >that is what happens! Did you happen to write down the name of the >rep that you spoke with? I would suggest writing them a detailed >letter giving the date that you called and spoke to their rep. It >may take a while to get it resolved but make sure that everything is >in writing. > >For everyone else who will ever have to speak to a rep over the >phone, always get a name and always follow up with a letter (or >email) back to that person stating what you understand from the >phone conversation, ie., " further to our telephone conversation this >morning with regard to ____________, I understand that ABC insurance >will cover costs for out of state medical treatment with Dr. >Blank ...... " . Make it as detailed as you can so that there is no >room for creative interpretation on their end. This way, you have a >started a paper trail and will have something to back you up should >your claim ever be denied. > >Daiga > > > > > > > > Before we started treating with Dr. Herzenberg I contacted Cigna to >find out > > if there would be any coverage at all because he is in another >state. > > Anyway, they assured me that we were participants in the " Seamless " >plan > > (meaning we can treat with doctors outside of New Jersey). Also, >she stated > > that Dr. Herzeberg was " In Network " for Cigna and we could go ahead >and make > > our appointment because there is no problem. I was so relieved >when she > > said that. So, on August 20th we started going to land and not >worrying > > about it at all. Today, Dr. Herzenberg's billing office called and >said > > Cigna kicked back almost every bill they have submitted. When I >called > > Cigna the story changed. They said that Dr. Herzenberg is being >paid by > > utilizing our " Out of Network " benefits because although Dr. >Herzenberg is > > " In Network " with Cigna he is not in the " Seamless " plan. I >explained that > > I spoke to a rep at Cigna and was assured there would be no issues >with this > > at all! Is it me? Does this just not makes sense to me? If Dr. >Herzenberg > > is " In Network " and I am in the " Seamless " plan shouldn't I have >complete > > coverage? Has anyone had such a problem? > > > > > > > > > > > > > > > > Mommy to (12-17-98) and > > > > Christian (1-30-04) LCF - DBB 23/7 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2004 Report Share Posted November 10, 2004 Hello , So true!! I know from my own experience...you talk to someone on the phone who " assures " you that everything is " fine " , " not a problem " and then weeks or even months later you get a letter in the mail saying the total opposite,(usually you owe x amount of $) meanwhile you had this niggling feeling in the back of your mind as you were talking to this person,(I think it is mommy alert) that something is just not right as this seems too easy. Then trying to actually speak with someone regarding your problem takes hours of pressing numbers, being transfered and listening to stupid automated voices. I have also taken names of reps, notice though that they will not give you their last name, so when you say " I spoke with " at a call center of who knows how many people, it means nothing to a big corporation...better to always get it in writing!!! I have learned (the hard way) that if a company will not either give me something in writing or respond to my detailed e-mail, then I will either not deal with them or if need be, like an isnurance co. I will keep asking to speak with a manager until I get a hold of someone who will give me something in writing! Sorry for the rant but this really pisses me off!!! I feel for you ! Like you need this stress on top of everything else! I would talk directly to Dr. Herzeberg and explain your situation. Wish you luck! - & Grace > > > > > > Before we started treating with Dr. Herzenberg I contacted Cigna to > find out > > if there would be any coverage at all because he is in another > state. > > Anyway, they assured me that we were participants in the " Seamless " > plan > > (meaning we can treat with doctors outside of New Jersey). Also, > she stated > > that Dr. Herzeberg was " In Network " for Cigna and we could go ahead > and make > > our appointment because there is no problem. I was so relieved > when she > > said that. So, on August 20th we started going to land and not > worrying > > about it at all. Today, Dr. Herzenberg's billing office called and > said > > Cigna kicked back almost every bill they have submitted. When I > called > > Cigna the story changed. They said that Dr. Herzenberg is being > paid by > > utilizing our " Out of Network " benefits because although Dr. > Herzenberg is > > " In Network " with Cigna he is not in the " Seamless " plan. I > explained that > > I spoke to a rep at Cigna and was assured there would be no issues > with this > > at all! Is it me? Does this just not makes sense to me? If Dr. > Herzenberg > > is " In Network " and I am in the " Seamless " plan shouldn't I have > complete > > coverage? Has anyone had such a problem? > > > > > > > > > > > > > > > > Mommy to (12-17-98) and > > > > Christian (1-30-04) LCF - DBB 23/7 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2004 Report Share Posted November 10, 2004 Hello , So true!! I know from my own experience...you talk to someone on the phone who " assures " you that everything is " fine " , " not a problem " and then weeks or even months later you get a letter in the mail saying the total opposite,(usually you owe x amount of $) meanwhile you had this niggling feeling in the back of your mind as you were talking to this person,(I think it is mommy alert) that something is just not right as this seems too easy. Then trying to actually speak with someone regarding your problem takes hours of pressing numbers, being transfered and listening to stupid automated voices. I have also taken names of reps, notice though that they will not give you their last name, so when you say " I spoke with " at a call center of who knows how many people, it means nothing to a big corporation...better to always get it in writing!!! I have learned (the hard way) that if a company will not either give me something in writing or respond to my detailed e-mail, then I will either not deal with them or if need be, like an isnurance co. I will keep asking to speak with a manager until I get a hold of someone who will give me something in writing! Sorry for the rant but this really pisses me off!!! I feel for you ! Like you need this stress on top of everything else! I would talk directly to Dr. Herzeberg and explain your situation. Wish you luck! - & Grace > > > > > > Before we started treating with Dr. Herzenberg I contacted Cigna to > find out > > if there would be any coverage at all because he is in another > state. > > Anyway, they assured me that we were participants in the " Seamless " > plan > > (meaning we can treat with doctors outside of New Jersey). Also, > she stated > > that Dr. Herzeberg was " In Network " for Cigna and we could go ahead > and make > > our appointment because there is no problem. I was so relieved > when she > > said that. So, on August 20th we started going to land and not > worrying > > about it at all. Today, Dr. Herzenberg's billing office called and > said > > Cigna kicked back almost every bill they have submitted. When I > called > > Cigna the story changed. They said that Dr. Herzenberg is being > paid by > > utilizing our " Out of Network " benefits because although Dr. > Herzenberg is > > " In Network " with Cigna he is not in the " Seamless " plan. I > explained that > > I spoke to a rep at Cigna and was assured there would be no issues > with this > > at all! Is it me? Does this just not makes sense to me? If Dr. > Herzenberg > > is " In Network " and I am in the " Seamless " plan shouldn't I have > complete > > coverage? Has anyone had such a problem? > > > > > > > > > > > > > > > > Mommy to (12-17-98) and > > > > Christian (1-30-04) LCF - DBB 23/7 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2004 Report Share Posted November 11, 2004 In the future, I will make someone send it to me in writing! I originally asked for a confirming letter and she said that was not common practice for Cigna. I should have asked for a Supervisor at that point - that was my fault. Mommy to (12-17-98) and Christian (1-30-04) LCF - DBB 23/7 _____ From: Daiga Grady Sent: Wednesday, November 10, 2004 11:22 PM To: nosurgery4clubfoot Subject: Re: Insurance Question Insurance companies make their money by charging premiums for services that will never be used and they do their best to see that that is what happens! Did you happen to write down the name of the rep that you spoke with? I would suggest writing them a detailed letter giving the date that you called and spoke to their rep. It may take a while to get it resolved but make sure that everything is in writing. For everyone else who will ever have to speak to a rep over the phone, always get a name and always follow up with a letter (or email) back to that person stating what you understand from the phone conversation, ie., " further to our telephone conversation this morning with regard to ____________, I understand that ABC insurance will cover costs for out of state medical treatment with Dr. Blank ...... " . Make it as detailed as you can so that there is no room for creative interpretation on their end. This way, you have a started a paper trail and will have something to back you up should your claim ever be denied. Daiga > > > Before we started treating with Dr. Herzenberg I contacted Cigna to find out > if there would be any coverage at all because he is in another state. > Anyway, they assured me that we were participants in the " Seamless " plan > (meaning we can treat with doctors outside of New Jersey). Also, she stated > that Dr. Herzeberg was " In Network " for Cigna and we could go ahead and make > our appointment because there is no problem. I was so relieved when she > said that. So, on August 20th we started going to land and not worrying > about it at all. Today, Dr. Herzenberg's billing office called and said > Cigna kicked back almost every bill they have submitted. When I called > Cigna the story changed. They said that Dr. Herzenberg is being paid by > utilizing our " Out of Network " benefits because although Dr. Herzenberg is > " In Network " with Cigna he is not in the " Seamless " plan. I explained that > I spoke to a rep at Cigna and was assured there would be no issues with this > at all! Is it me? Does this just not makes sense to me? If Dr. Herzenberg > is " In Network " and I am in the " Seamless " plan shouldn't I have complete > coverage? Has anyone had such a problem? > > > > > > > > Mommy to (12-17-98) and > > Christian (1-30-04) LCF - DBB 23/7 > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2004 Report Share Posted November 11, 2004 Thanks . I called his office last night but I think they were gone. I am going to speak to someone today. Just for the record, even Dr. Herzenberg's office never heard of such a thing. It all sounds a little fishy to me! Mommy to (12-17-98) and Christian (1-30-04) LCF - DBB 23/7 _____ From: Sent: Thursday, November 11, 2004 12:58 AM To: nosurgery4clubfoot Subject: Re: Insurance Question Hello , So true!! I know from my own experience...you talk to someone on the phone who " assures " you that everything is " fine " , " not a problem " and then weeks or even months later you get a letter in the mail saying the total opposite,(usually you owe x amount of $) meanwhile you had this niggling feeling in the back of your mind as you were talking to this person,(I think it is mommy alert) that something is just not right as this seems too easy. Then trying to actually speak with someone regarding your problem takes hours of pressing numbers, being transfered and listening to stupid automated voices. I have also taken names of reps, notice though that they will not give you their last name, so when you say " I spoke with " at a call center of who knows how many people, it means nothing to a big corporation...better to always get it in writing!!! I have learned (the hard way) that if a company will not either give me something in writing or respond to my detailed e-mail, then I will either not deal with them or if need be, like an isnurance co. I will keep asking to speak with a manager until I get a hold of someone who will give me something in writing! Sorry for the rant but this really pisses me off!!! I feel for you ! Like you need this stress on top of everything else! I would talk directly to Dr. Herzeberg and explain your situation. Wish you luck! - & Grace > > > > > > Before we started treating with Dr. Herzenberg I contacted Cigna to > find out > > if there would be any coverage at all because he is in another > state. > > Anyway, they assured me that we were participants in the " Seamless " > plan > > (meaning we can treat with doctors outside of New Jersey). Also, > she stated > > that Dr. Herzeberg was " In Network " for Cigna and we could go ahead > and make > > our appointment because there is no problem. I was so relieved > when she > > said that. So, on August 20th we started going to land and not > worrying > > about it at all. Today, Dr. Herzenberg's billing office called and > said > > Cigna kicked back almost every bill they have submitted. When I > called > > Cigna the story changed. They said that Dr. Herzenberg is being > paid by > > utilizing our " Out of Network " benefits because although Dr. > Herzenberg is > > " In Network " with Cigna he is not in the " Seamless " plan. I > explained that > > I spoke to a rep at Cigna and was assured there would be no issues > with this > > at all! Is it me? Does this just not makes sense to me? If Dr. > Herzenberg > > is " In Network " and I am in the " Seamless " plan shouldn't I have > complete > > coverage? Has anyone had such a problem? > > > > > > > > > > > > > > > > Mommy to (12-17-98) and > > > > Christian (1-30-04) LCF - DBB 23/7 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2004 Report Share Posted November 11, 2004 Hi , I don't think it was your fault at all, we are all trusting people and are that way until someone gives a reason not to be...these are all good lessons learned ) - > > > > > > Before we started treating with Dr. Herzenberg I contacted Cigna to > find out > > if there would be any coverage at all because he is in another > state. > > Anyway, they assured me that we were participants in the " Seamless " > plan > > (meaning we can treat with doctors outside of New Jersey). Also, > she stated > > that Dr. Herzeberg was " In Network " for Cigna and we could go ahead > and make > > our appointment because there is no problem. I was so relieved > when she > > said that. So, on August 20th we started going to land and not > worrying > > about it at all. Today, Dr. Herzenberg's billing office called and > said > > Cigna kicked back almost every bill they have submitted. When I > called > > Cigna the story changed. They said that Dr. Herzenberg is being > paid by > > utilizing our " Out of Network " benefits because although Dr. > Herzenberg is > > " In Network " with Cigna he is not in the " Seamless " plan. I > explained that > > I spoke to a rep at Cigna and was assured there would be no issues > with this > > at all! Is it me? Does this just not makes sense to me? If Dr. > Herzenberg > > is " In Network " and I am in the " Seamless " plan shouldn't I have > complete > > coverage? Has anyone had such a problem? > > > > > > > > > > > > > > > > Mommy to (12-17-98) and > > > > Christian (1-30-04) LCF - DBB 23/7 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2004 Report Share Posted November 11, 2004 I do not have this insurance but I have had multiple problems with insurance companies. I loathe them. What I have learned is to check out your company's process for formal appeal in writing. I had an issue after Kelsey was born where they tried to charge me more of a copay because she was a " sick baby " because of the clubfoot diagnosis, even though no one touched her foot in the hospital. I got jerked around from customer service person to customer service person on the phone, each one giving me a slightly different answer. I got sick of it and filed a formal appeal with all of the dates, conversations, etc and we won the appeal. I think sometimes they decline things just because they think people won't fight it. Stick to your guns. Jenni Gerace wrote: >Thanks . I called his office last night but I think they were gone. >I am going to speak to someone today. Just for the record, even Dr. >Herzenberg's office never heard of such a thing. It all sounds a little >fishy to me! > > > > > >Mommy to (12-17-98) and > >Christian (1-30-04) LCF - DBB 23/7 > > _____ > >From: >Sent: Thursday, November 11, 2004 12:58 AM >To: nosurgery4clubfoot >Subject: Re: Insurance Question > > > > >Hello , > >So true!! I know from my own experience...you talk to someone on the >phone who " assures " you that everything is " fine " , " not a problem " >and then weeks or even months later you get a letter in the mail >saying the total opposite,(usually you owe x amount of $) meanwhile >you had this niggling feeling in the back of your mind as you were >talking to this person,(I think it is mommy alert) that something is >just not right as this seems too easy. Then trying to actually speak >with someone regarding your problem takes hours of pressing numbers, >being transfered and listening to stupid automated voices. > >I have also taken names of reps, notice though that they will not >give you their last name, so when you say " I spoke with " at a >call center of who knows how many people, it means nothing to a big >corporation...better to always get it in writing!!! I have learned >(the hard way) that if a company will not either give me something in >writing or respond to my detailed e-mail, then I will either not deal >with them or if need be, like an isnurance co. I will keep asking to >speak with a manager until I get a hold of someone who will give me >something in writing! > >Sorry for the rant but this really pisses me off!!! > >I feel for you ! Like you need this stress on top of >everything else! I would talk directly to Dr. Herzeberg and explain >your situation. > >Wish you luck! > >- & Grace > > > > >> >> >>> >>> >>>Before we started treating with Dr. Herzenberg I contacted Cigna >>> >>> >to > > >>find out >> >> >>>if there would be any coverage at all because he is in another >>> >>> >>state. >> >> >>>Anyway, they assured me that we were participants in >>> >>> >the " Seamless " > > >>plan >> >> >>>(meaning we can treat with doctors outside of New Jersey). Also, >>> >>> >>she stated >> >> >>>that Dr. Herzeberg was " In Network " for Cigna and we could go >>> >>> >ahead > > >>and make >> >> >>>our appointment because there is no problem. I was so relieved >>> >>> >>when she >> >> >>>said that. So, on August 20th we started going to land and >>> >>> >not > > >>worrying >> >> >>>about it at all. Today, Dr. Herzenberg's billing office called >>> >>> >and > > >>said >> >> >>>Cigna kicked back almost every bill they have submitted. When I >>> >>> >>called >> >> >>>Cigna the story changed. They said that Dr. Herzenberg is being >>> >>> >>paid by >> >> >>>utilizing our " Out of Network " benefits because although Dr. >>> >>> >>Herzenberg is >> >> >>> " In Network " with Cigna he is not in the " Seamless " plan. I >>> >>> >>explained that >> >> >>>I spoke to a rep at Cigna and was assured there would be no >>> >>> >issues > > >>with this >> >> >>>at all! Is it me? Does this just not makes sense to me? If Dr. >>> >>> >>Herzenberg >> >> >>>is " In Network " and I am in the " Seamless " plan shouldn't I have >>> >>> >>complete >> >> >>>coverage? Has anyone had such a problem? >>> >>> >>> >>> >>> >>> >>> >>>Mommy to (12-17-98) and >>> >>>Christian (1-30-04) LCF - DBB 23/7 >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
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