phixer
01-26-2004, 07:22 AM
I won! YEAH! Yahoo! YeaHa!!!
As you can tell I’m a little happy because I won the battle with my insurance company and they are going to pay for my Remicade treatments. I had been on Remicade and it was working well for me but I had to change insurance providers and the new company refused pay for the Remicade treatments because it has not been FDA approved for PA. Unfortunately, or maybe fortunately, the doctor’s office didn’t stop the treatments until the bills were high enough to pay for a new car and a damn nice one at that. Well after a year of appeals and all of the phone calls they finally gave in, said that the will pay the past bills and will pay for future treatments. Mary-Jo at Health Connections, who is the Remicade rep, was great. She got everything organized for the doctor’s office and I to send to the insurance company. Mary-Jo also did a great job of calming me down so I wouldn’t call up my insurance company and start screaming at them, it’s amazing how short a persons temper can get when everything hurts. I think that sending the complaint letter and supporting documentation to the state insurance commissioner and the same time we sent the last appeal to the insurance company was the clincher. I imagine they probably got a call form the state inquiring about my situation and realized I wasn’t going to give up. For everyone out there going through the same thing, Good Luck to you, keep working on your insurance company and never give up. We are the ones with something to lose, our health and quality of life. So get the insurance companies to do what they are paid to do, pay the bills to get us healthy again. Well I don’t think we see enough good news here so I just wanted to share mine to show that good things do happen.
As you can tell I’m a little happy because I won the battle with my insurance company and they are going to pay for my Remicade treatments. I had been on Remicade and it was working well for me but I had to change insurance providers and the new company refused pay for the Remicade treatments because it has not been FDA approved for PA. Unfortunately, or maybe fortunately, the doctor’s office didn’t stop the treatments until the bills were high enough to pay for a new car and a damn nice one at that. Well after a year of appeals and all of the phone calls they finally gave in, said that the will pay the past bills and will pay for future treatments. Mary-Jo at Health Connections, who is the Remicade rep, was great. She got everything organized for the doctor’s office and I to send to the insurance company. Mary-Jo also did a great job of calming me down so I wouldn’t call up my insurance company and start screaming at them, it’s amazing how short a persons temper can get when everything hurts. I think that sending the complaint letter and supporting documentation to the state insurance commissioner and the same time we sent the last appeal to the insurance company was the clincher. I imagine they probably got a call form the state inquiring about my situation and realized I wasn’t going to give up. For everyone out there going through the same thing, Good Luck to you, keep working on your insurance company and never give up. We are the ones with something to lose, our health and quality of life. So get the insurance companies to do what they are paid to do, pay the bills to get us healthy again. Well I don’t think we see enough good news here so I just wanted to share mine to show that good things do happen.