Insurance Company Denial
Posted: Fri Jan 06, 2006 3:34 pm
Atlantic Blue Cross has denied my claim for LDN. I submitted a special authorization form (after it was denied the first time) that the neurologist filled out, and they still won't allow me to put my prescription costs for LDN through for reimbursement. It reads "Established payment criteria indicates that Revia is not reimbursed for treatment of MS".
There are so many things wrong with this. First of all, shouldn't the medical "professionals" decide what will or won't treat MS (well, ultilmately the person afflicted should be able to decide what they want to do for a disease that there is no real treatment anyway), but these are the money people, the insurance guys -why don't they just do what is recommended for a medical condition when told by someone who took medicine at school, not accounting!
But the best part is the letter itself. It's addressed to the doctor, not to me. I'm copied on it! They're telling him that they won't reimburse me, didn't even bother to include me in the "Dear" part, I'm cc'd. My doctor really doesn't give a crap one way or another, its just his job, he'll get this letter and wonder who is this? Is this one of mine? (we're all cattle). And it's my claim, not his!
Just stupid. And discouraging. I didn't even want to challenge it because I didn't want to draw attention from anywhere at work that might out me. I just don't want to reveal anything, I'm not comfortable with it. But then I thought, well, I'll just do this one thing, get the doctor to fill in his "confirmation/recommendation" part, it won't be any big deal with a doctor's note.
In the end it won't come up at work and I'll continue to get it and be thankful it's as affordable as it is. The neurologist wants me on a CRAB drug. I wonder what happens when I put that through? Won't that be ridiculous if they approve a drug at $1500/month but not $50?
A rant.
There are so many things wrong with this. First of all, shouldn't the medical "professionals" decide what will or won't treat MS (well, ultilmately the person afflicted should be able to decide what they want to do for a disease that there is no real treatment anyway), but these are the money people, the insurance guys -why don't they just do what is recommended for a medical condition when told by someone who took medicine at school, not accounting!
But the best part is the letter itself. It's addressed to the doctor, not to me. I'm copied on it! They're telling him that they won't reimburse me, didn't even bother to include me in the "Dear" part, I'm cc'd. My doctor really doesn't give a crap one way or another, its just his job, he'll get this letter and wonder who is this? Is this one of mine? (we're all cattle). And it's my claim, not his!
Just stupid. And discouraging. I didn't even want to challenge it because I didn't want to draw attention from anywhere at work that might out me. I just don't want to reveal anything, I'm not comfortable with it. But then I thought, well, I'll just do this one thing, get the doctor to fill in his "confirmation/recommendation" part, it won't be any big deal with a doctor's note.
In the end it won't come up at work and I'll continue to get it and be thankful it's as affordable as it is. The neurologist wants me on a CRAB drug. I wonder what happens when I put that through? Won't that be ridiculous if they approve a drug at $1500/month but not $50?
A rant.