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Topic: ya ready for this sh*t? (Read 146 times) |
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PollyPocket
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ya ready for this sh*t?
« on: Feb 6th, 2008, 6:39pm » |
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I went to the dr. back in Oct, (I think I had bronchitis again) and did get a prescription (prolly a z-pack). Both are documented in my checkbook as going to the dr. and getting the script.
I got a letter today from the insurance company denying my claim. Why?
Not medically necessary. 
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“Life is all about timing... the unreachable becomes reachable, the unavailable become available, the unattainable... attainable. Have the patience, wait it out It's all about timing.” - Stacey Charter
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Gator
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Re: ya ready for this sh*t?
« Reply #1 on: Feb 6th, 2008, 6:51pm » |
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Did they deny the whole doctor visit or just the script? If it was just the script, it could be that the meds the doc prescribed are not in your insurance company's formulary. When I lost my job and insurance and went under my wife's insurance, I had to quit using Zomig NS and start using Imitrex injections for that reason.
They do that shit because most people won't question it. They just roll over and pay. F@#$ing insurance companies. Fight it.
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chewy
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Re: ya ready for this sh*t?
« Reply #2 on: Feb 6th, 2008, 6:51pm » |
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What was the official diagnosis? Have your Doc call the insurance company and spell it out for them.
Z-packs aren't prescibed for no particular reason for Christ sakes. Its a high potentancy antibiotic. I know cause I just finished one.
Even if its not in the formulary the Doc can make it a medical neccesity and get it covered for you.
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| « Last Edit: Feb 6th, 2008, 6:54pm by chewy » |
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Brew
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Re: ya ready for this sh*t?
« Reply #3 on: Feb 6th, 2008, 8:50pm » |
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on Feb 6th, 2008, 6:51pm, chewy wrote:Z-packs aren't prescibed for no particular reason for Christ sakes. Its a high potentancy antibiotic. I know cause I just finished one.
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Was I right? Did you start feeling better around day 3? How you doin' now?
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Always remember that you're unique, just like everyone else.
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chewy
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Re: ya ready for this sh*t?
« Reply #4 on: Feb 6th, 2008, 8:57pm » |
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Yup. Around the third day I started to feel like I'd live.
Still not 100% but getting closer.
Next step is the Chantix to quit smoking.
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Jonny
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Re: ya ready for this sh*t?
« Reply #5 on: Feb 6th, 2008, 8:58pm » |
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Jen baby, all you need is a weekend with me and you will be a whole new woman (just a little more happy)
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It is up to YOU to educate yourself and then help your doctor plan your treatment. If you just sit down in front of your doctor and say "make me better" you are setting yourself up for a great deal of pain.
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PollyPocket
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Re: ya ready for this sh*t?
« Reply #6 on: Feb 6th, 2008, 10:04pm » |
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on Feb 6th, 2008, 8:58pm, Jonny wrote:Jen baby, all you need is a weekend with me and you will be a whole new woman (just a little more happy)
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I'm buying the ticket on Friday
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“Life is all about timing... the unreachable becomes reachable, the unavailable become available, the unattainable... attainable. Have the patience, wait it out It's all about timing.” - Stacey Charter
"If I don't remember it happening, it never happened. " - Tori
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purpleydog
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Re: ya ready for this sh*t?
« Reply #7 on: Feb 7th, 2008, 5:55pm » |
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You've got to be kidding me, Jen. Z-packs are generic now. I'd have the doc write a letter, then get on the phone with the insurance, and ask them why they didn't cover it. Then ask them what doctor of theirs you saw, who deemed this medically unnecessary. Then when they give you their line of crap, get a supervisor on the phone. Ask them how they can possibly know if it was unnecessary, if you weren't seen by their doc. I'd think that they'd cover a z-pack at a few dollars, as opposed to uncontrolled bronchitis, and ending up in the hospital with complications, and having to pay for that.
Ass holes.
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PollyPocket
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Re: ya ready for this sh*t?
« Reply #8 on: Feb 7th, 2008, 6:15pm » |
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I did speak to the bitch at the ins. co today. Seems because I didn't specify a pcp, the ins co decided for me who I'd be seeing, only neglected to tell me that.
So when I went to my regular doc ( I got the ins. in May, didn't use it till Oct - ch wasnt covered so I didnt pay attn to it then)
Apparently, since they issued a doctor to me, and I went to my reg doc, they classified it as "urgent care" and because the bronchitis could've been handled by my (their) pcp, they won't cover it.
I spoke with our rep today, and he is going to look into it, but I am going to appeal this. The "doc" they named I've never even heard of much less seen.
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“Life is all about timing... the unreachable becomes reachable, the unavailable become available, the unattainable... attainable. Have the patience, wait it out It's all about timing.” - Stacey Charter
"If I don't remember it happening, it never happened. " - Tori
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