My lawyer is suing (says he is anyway) the doctor that won't return my $871 he owes me because they haven't listened to him either. JEAN
"A true friend walks in when the rest of the world walks out."
>----- Original Message -----
From: "Helen Dynda" <olddad66@runestone.net>
To: "Multiple recipients of list ADHESIONS" <adhesions@mail.medispecialty.com>
Sent: Tuesday, April 03, 2001 3:04 PM
Subject: HOW TO FIGHT BACK WHEN INSURANCE WON'T PAY...
HOW TO FIGHT BACK WHEN INSURANCE WON'T PAY...
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1.) How to Fight Back
http://www.onhealth.com/conditions/in-depth/item/item,4271_1_1.asp
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2.) Calling in the Troops
http://onhealth.com/conditions/in-depth/item/item,4271_1_2.asp
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3.) A Step-By-Step Guide ... from the book, "Managed Care Made Easy: Survival in the HMO Era"
http://onhealth.com/conditions/in-depth/item/item,4341_1_1.asp
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4.) What you need to know about the Appeals Process: A primer for patients by the Patient Advocacy Coalition Colorado Ombudsman for Managed Care
http://www.patientadvocacy.com/appeals.htm
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5.) How to...Challenge a HMO's Denial of Coverage ... Click: Health ... Click: Conditions and Treatments ... Click: Family Health ... Scroll down to article
http://www.ehow.com/eHow/eHow/0,1053,3692,00.html
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From: Chrissy492@aol.com Wed, 18 Oct 2000 12:16:38 EDT
What I did was get letters from all my doctors saying what they could not do for me and what Scranton doctors could do for me. I also typed up a letter to go along with those letters, submitted them to my health insurance -- and now they are looking to pay more than what they did pay.
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From: Kate Murphy (katemm@mindspring.com)
February 25, 2001 12:38 PM
Make sure that you exhaust all your options. I believe in NY state you can get a review by the Commissioner of Insurance as well as your own insurance company. Ask for the entire appeals process to be spelled out for you -- which by law they must do.
Sometimes the insurance companies will pay for a procedure for an individual to avoid getting it kicked up higher and establishing a policy. This was true for several of my friends who asked Blue Cross to cover bone marrow transplants for breast cancer. The insurance paid; but did not establish policy so that they would have to pay for others. A fine point, but one that might help you get your surgery in PA paid for.
-- Kate Murphy~ ~ ~ ~
From: Kathy L. (jkluch@msn.com)
March 13, 2001 8:46 PM
Dear Karla:
I read your posting with great sadness. I too felt that this site saved my life when things seemed so awful for me, and it seems to have taken a turn for the worse. Please accept my sympathy to you and your family for your loss. You are all in my prayers.
I appreciate the fact that you reconsidered and left your story on the quilt. It helped me more than you could ever know. I used it along with other examples to appeal to my insurance for payment for my surgery out of town. These stories helped me make the point that some surgeons do not know how to deal with adhesions and the insurance companies have to be willing to look at each case individually. I told them that I could have had multiple surgeries which would have cost them more money and caused me more suffering. Thank you for sharing your story, it helped me win my appeal.
Take care,
Kathy
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