Coleen's update, 1-28-2010

[Guest guest]

hi all,

Just wanted to tell you all something real quick here.

When I was supposed to get injections for my back pain the doctor's office

called and said that the Oregon Health PLan Plus said the procedures for that

were *over the line* so they wouldn't pay for them. 

Now my doctor wants me to see a Physical Therapist.  The Physical Therapist

office called yesterday and told me that the procedures were *under the line*

and therefore the Oregon Health Plan Plus wouldn't pay for them.  HUH!  Does

that mean any procedures have to be right *on* the line so they will pay for

them?  I asked the gal for those procedure numbers, so now I have both sets of

procedure numbers that doctors wanted done for my back.  Also, the procedure

that is for the *chronic back pain* is *below the line*, go figure!  My

insurance, OHP Plus,  will pay for my medications basically but not for any real

help.  I don't get it.

I have to call OHP and see what if anything they  can tell me. 

I just can't believe it.  First I am over the line that they will pay for, which

makes sense, now I am under the line that they will pay for.  I don't understand

how this works.

Is anyone else dealing with this sort of thing?  Anyone in Oregon?

jeezzzzzzz,

hugs, Coleen

[Guest guest]

It is crazy isn't it??  I mean I can understand when they say that the procedure

is over the line so Oregon Health Plan won't pay for it because it sounds like

procedure costs too much for them to pay for. 

When a procedure is under the line and they won't pay for it, it does not make

sense. 

Does anyone else understand this stuff?  Anyone?

Makes me want to shake my head back and forth really fast in amazement! 

Please, I need things to make sense to me.  What a crazy world we live in.

At this point I am thinking, heck, I will just do the patches and not get

injections.  Besides

I don't like the idea of them poking something near my nerves in my back,

doesn't sound

very guaranteed.  Patches are on my skin and are not bothering my skin yet.  I

just hope my insurance keeps paying for them. 

I was also thinking, the Oregon Health Plan PLus won't do my injections, won't

give me physical therapy, Will pay for my oral medications,   Will they pay for

Surgery?  I do not want surgery, but since they don't make sense to me yet

because they won't pay for injections or physical therapy would they rather pay

more and offer me surgery instead.

I can't wait to hear what my doctor says about the fax she is getting from the

physical therapy doctor that my insurance won't pay for physical therapy.  My

doctor will not be happy, I know that  much.

I went to the dentist alot because I am getting dentures and they basically

pulled one tooth at a time every 3 weeks till they got all the back teeth out. 

They are doing impressions now for the dentures.  Maybe that is affecting what

they are allocating for my back issues.

I just don't know.  Need to call Oregon Health Plan soon.

going crazy,

Coleen

________________________________

From: grasshopperx_10 <woody1014@...>

neck pain

Sent: Thu, January 28, 2010 8:18:37 AM

Subject: Re: Coleen's update, 1-28-2010

What the heck does that mean Coleen? I wonder too?

>

> hi all,

>

> Just wanted to tell you all something real quick here.

>

> When I was supposed to get injections for my back pain the doctor's office

called and said that the Oregon Health PLan Plus said the procedures for that

were *over the line* so they wouldn't pay for them. 

>

> Now my doctor wants me to see a Physical Therapist.  The Physical Therapist

office called yesterday and told me that the procedures were *under the line*

and therefore the Oregon Health Plan Plus wouldn't pay for them.  HUH!  Does

that mean any procedures have to be right *on* the line so they will pay for

them?  I asked the gal for those procedure numbers, so now I have both sets of

procedure numbers that doctors wanted done for my back.  Also, the procedure

that is for the *chronic back pain* is *below the line*, go figure!  My

insurance, OHP Plus,  will pay for my medications basically but not for any real

help.  I don't get it.

> I have to call OHP and see what if anything they  can tell me. 

>

> I just can't believe it.  First I am over the line that they will pay for,

which makes sense, now I am under the line that they will pay for.  I don't

understand how this works.

>

> Is anyone else dealing with this sort of thing?  Anyone in Oregon?

>

> jeezzzzzzz,

>

> hugs, Coleen

>

>

>     

>

>

[Guest guest]

I would bet Coleen, that they would rather pay for a huge$$$$ surgery! Heres how

you figure it out. It all works backward. What ever is the most stupid, thats

what they want. In the last two years with health issurance, unemployment(dave)

and a federal legal case. Thats the conclusion we have come to. We have a

personal joke going. we call those people ROCKS.They think like rocks, course

rocks dont think. Remember they are all rocks! And if you get on the telephone

and keep calling.... They will either pay it,or mess it up more! cindy

>

> It is crazy isn't it??  I mean I can understand when they say that the

procedure is over the line so Oregon Health Plan won't pay for it because it

sounds like procedure costs too much for them to pay for. 

>

> When a procedure is under the line and they won't pay for it, it does not make

sense. 

>

> Does anyone else understand this stuff?  Anyone?

>

> Makes me want to shake my head back and forth really fast in amazement! 

> Please, I need things to make sense to me.  What a crazy world we live in.

>

> At this point I am thinking, heck, I will just do the patches and not get

injections.  Besides

> I don't like the idea of them poking something near my nerves in my back,

doesn't sound

> very guaranteed.  Patches are on my skin and are not bothering my skin yet.  I

just hope my insurance keeps paying for them. 

>

> I was also thinking, the Oregon Health Plan PLus won't do my injections, won't

give me physical therapy, Will pay for my oral medications,   Will they pay for

Surgery?  I do not want surgery, but since they don't make sense to me yet

because they won't pay for injections or physical therapy would they rather pay

more and offer me surgery instead.

>

> I can't wait to hear what my doctor says about the fax she is getting from the

physical therapy doctor that my insurance won't pay for physical therapy.  My

doctor will not be happy, I know that  much.

>

> I went to the dentist alot because I am getting dentures and they basically

pulled one tooth at a time every 3 weeks till they got all the back teeth out. 

They are doing impressions now for the dentures.  Maybe that is affecting what

they are allocating for my back issues.

>

> I just don't know.  Need to call Oregon Health Plan soon.

>

> going crazy,

>

> Coleen

>

>

>

>

> ________________________________

> From: grasshopperx_10 <woody1014@...>

> neck pain

> Sent: Thu, January 28, 2010 8:18:37 AM

> Subject: Re: Coleen's update, 1-28-2010

>

>

> What the heck does that mean Coleen? I wonder too?

> >

> > hi all,

> >

> > Just wanted to tell you all something real quick here.

> >

> > When I was supposed to get injections for my back pain the doctor's office

called and said that the Oregon Health PLan Plus said the procedures for that

were *over the line* so they wouldn't pay for them. 

> >

> > Now my doctor wants me to see a Physical Therapist.  The Physical Therapist

office called yesterday and told me that the procedures were *under the line*

and therefore the Oregon Health Plan Plus wouldn't pay for them.  HUH!  Does

that mean any procedures have to be right *on* the line so they will pay for

them?  I asked the gal for those procedure numbers, so now I have both sets of

procedure numbers that doctors wanted done for my back.  Also, the procedure

that is for the *chronic back pain* is *below the line*, go figure!  My

insurance, OHP Plus,  will pay for my medications basically but not for any real

help.  I don't get it.

> > I have to call OHP and see what if anything they  can tell me. 

> >

> > I just can't believe it.  First I am over the line that they will pay for,

which makes sense, now I am under the line that they will pay for.  I don't

understand how this works.

> >

> > Is anyone else dealing with this sort of thing?  Anyone in Oregon?

> >

> > jeezzzzzzz,

> >

> > hugs, Coleen

> >

> >

> >     

> >

> >