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(Message started by: CarrieBethRN on Aug 4th, 2004, 7:52pm)

Title: O2 issues
Post by CarrieBethRN on Aug 4th, 2004, 7:52pm
Have some questions regarding a few issues about O2!  When I started school at Jefferson, I had to switch over to Aetna HMO student insurance from being cobra'd on my mom's blue cross plan.  Well, as much as it seemed like it was going to save us some money...it's definately not!  So far, hardly any of my prescription meds have been on the 'approved' list for Aetna so I've had to get them all precertified, and then Aetna charges $35 a script.  Quite expensive for someone like me!

At any rate, besides the point...my mom recently got this bill in the mail from the O2 supplier charging over $300 for a monthly rental fee for the H tank and around $65 for the 4 E tanks I have.  Surprised me!!  We never even knew there was a monthly charge on the equipment if you didn't get it refilled every single month....  Plus we've only ever had the copays.

Well as it turns out, Aetna HMO does not cover DME which includes home oxygen.  I called them, and they said that if my neuro prior authorized it (once again!) then they would cover it.  I've been on the phone back and forth with the headache center yesterday and today about this, and the insurance has denied the prior authorizations.  I called the insurance company and again they said it just needed to be prior authorized.  So, the nurse from the neuro office called them again, and I guess now it is in the pending stage.  She didn't know what supplier I got the O2 from, so she gave them the name of the one they recommend, which isn't the one I use..hopefully we'll be able to switch it over so that they will pay the bill for last month!!

Does anyone have any experience dealing with this kind of thing?  Sometimes it gets a little overwhelming to me, and I don't really know a lot about it and what I can do to fight it if they do deny it again!  Frank (Jeepgun) today suggested looking into Welder's O2.  Just was wondering how to go about that and the average costs.  Do you have to get a different kind of regulator?  So far, I have tubing and nonrebreather masks.  I have a regulator on the H tank and 2 E tank regulators (one here and one at home).  I may have to return those regulators if I have to return the tanks, though!

Sorry for the length of this post.  If anyone can give some suggestions, it would be greatly appreciated!  Thanks!

Carrie :)

Title: Re: O2 issues
Post by jhammer on Aug 4th, 2004, 8:03pm
The next time I go through something like that (with the insurance company and the doctor's perscription thing) I'm gonna get the doctor, the insurance company, and pharmacy all on a conference call.  

That 'preauthorization' thing is BULL-SHIT!  Why should the doctor (and patient) have to go through all that, they perscribed it for a reason, to make you better.


ARGH! I'm getting a headache just thinking about it.

Title: Re: O2 issues
Post by Jonny on Aug 4th, 2004, 8:03pm
Hey Chicky,

On the welders 02, if you can rent a tank I will have a custom built regulator to fit it.....15LPM.....N/C ;;D

........................................jonny

Title: Re: O2 issues
Post by Leesa on Aug 4th, 2004, 8:04pm
Carrie, get with Jonny the O2 guru on the welder's O2 gal and Im sure he will give you all you need to know! Sorry I cant be of any more help hun. But Im here if ya need me!! Love ya and Miss ya lots!!!!!
Leesa  ;;D

Title: Re: O2 issues
Post by CarrieBethRN on Aug 4th, 2004, 8:12pm
Thanks soooooooooo much for the ideas!  :)  I am going to give the headache center and insurance company a few days to try to work this out, but in the meantime I will try to ask my dad about looking into the Welder's O2 for me.  He used to work for a welding company (years ago), and he may still have some connections here or there!!  Jonny..your help is GREATLY appreciated, and I will let you know if that's what I end up doing!

jhammer...I can only call the headache center and insurance company on days when I am not feeling too bad because yeah...it'll definately cause a nasty pain in the head trying to work all this out!! LMAO


Hugz,
Carrie :)

P.S. Leesa..miss you too!!! :)

Title: Re: O2 issues
Post by IndianaJohn on Aug 4th, 2004, 8:15pm
Hi Carrie, sorry your having trouble with the insurance.  What we go through is bad enough without that kind of B.S.  

I just went through the prior authorization thing for my Imitrex.  It can be done, but it takes time and persistance and help from the doc's office.  Sometimes having the insurance company send a fax to the doc's office and have them fill it out and send it back works quickly sometimes not.  I would have them do both, that way they have the paper work insurance companies love so much.

They key is persistance.

Also keep track of the names of the people you talk to, that can be important.  Sometimes when you're talking to an insurance company and they ask "well, who did you talk to?" and if you don't know, the whole process can be stalled.

Monthly rental fees are customary for equipment unless you own it.  Which in the long run may be cheaper depending on your situation.

Get the O2 providers name corrected ASAP.  This will cause a lot of confusion and delay things otherwise.

As for the welders tank adaptation.  Other are much more knowledgable tha myself.  I do know that the initial price for regulators can be kind of steep, but I don't have a ball park figure.

Hope this helps

John

Title: Re: O2 issues
Post by Carl_D on Aug 4th, 2004, 8:21pm
The regulator was one of my big questions, since I have been trying since APRIL to get medical o2 and have fallen into the same sordid buerocratic bullshit. (if I can't spell...I've been awake WAYYYY to fucking long!)

Guess my o2 regulator isn't worth squat now!  >:(

Red eyed,
Carl D

Not to mention - I don't have a fricken clue where to get welding o2 around here!

Title: Re: O2 issues
Post by jhammer on Aug 4th, 2004, 8:27pm
Is the welding O2 of the same quality as the medicinal type?  

I guess oxygen is oxygen but I remember when I used to play with cars...we would get Nitrous Oxide tanks for the races and people would always say "don't try to use it like the dentist uses it, they put stuff in it so you can't".  Now I've never tried so I don't know if that's true or not but it would be logical (in my mind at least) that if that were true then the gas companies would do the same with welding tanks to prevent the same kind of misuse.

I'm sure someone has some experience with this...please enlighten me, I may have some welding tanks at my disposal.

~Jake

Title: Re: O2 issues
Post by Jonny on Aug 4th, 2004, 8:45pm

on 08/04/04 at 20:15:23, IndianaJohn wrote:
As for the welders tank adaptation.  Other are much more knowledgable tha myself.  I do know that the initial price for regulators can be kind of steep, but I don't have a ball park figure.


John, thats why my post said "N/C".......I own a welding company and have been converting them for years for clusterheads N/C.

Carl.....call my cell ass-hole ;;D

Jake, 02 that goes into medical tanks is the same 02 that goes into welding tanks, the only diff is that the state inspects the medical 02 tanks yearly.......you must make sure you dont get an old rusty welding tank.

..................................jonny



Title: Re: O2 issues
Post by E-Double on Aug 4th, 2004, 8:49pm

on 08/04/04 at 20:45:49, Jonny wrote:
John, thats why my post said "N/C".......I own a welding company and have been converting them for years for clusterheads N/C.

Carl.....call my cell ass-hole ;;D

Jake, 02 that goes into medical tanks is the same 02 that goes into welding tanks, the only diff is that the state inspects the medical 02 tanks yearly.......you must make sure you dont get an old rusty welding tank.

..................................jonny



You the MACK!!!
That is what family is all about!!
You rock Jonny!!!

Eric

Title: Re: O2 issues
Post by Cerberus on Aug 4th, 2004, 11:59pm
Ya know...

 Woobs has dealt with the insurance companies on my O2 and accessories mostly so I may be wrong, however, I believe all it took for us to get approval from BCBS was a letter of necessity.
 Course it probably doesnt help ya any being you are with Aetna now but seems to me they can't deny you of something your physician has specifically written that you have to have...
 Am I mistaken? worth a look see in any event.

Bummer you got O2 woes...
Ramon

Title: Re: O2 issues
Post by CarrieBethRN on Aug 5th, 2004, 12:14am
Yeah definately all it SHOULD have taken was a phone call or a letter to the insurance company.  But after both a phone call and a letter, the insurance company turned them down and then turned around and told me that all it took was prior authorization.   [smiley=ohjez.gif]  They are working on it some more now!

I talked to my dad on the phone tonight, and he said he can get ahold of some Welders O2 if needed.  He also said, "That doesn't take care of the $359 bill that you got for the tank in your closet!" LMAO  true true...

Then I thought of something else rather ironically funny.

9 stories down right below my window are two gigantic liquid oxygen tanks that are refilled quite frequently and supply O2 to all of Jefferson's hospitals right around here!  Who wants to come help me tap into it and get a line running up to my apartment? LOL!!

Thanks again, all!

Carrie :)

Title: Re: O2 issues
Post by BruceD on Aug 5th, 2004, 9:26am

on 08/05/04 at 00:14:32, CarrieBethRN wrote:
9 stories down right below my window are two gigantic liquid oxygen tanks that are refilled quite frequently and supply O2 to all of Jefferson's hospitals right around here!  Who wants to come help me tap into it and get a line running up to my apartment? LOL!!


Oh great, now I've got a mental image of Jonny the masked avenger tappin' into that big tank & then runnin' beautiful brushed stainless pipe right up to your room. At least he'd do it right. That's better than the redneck way of doin' it ... "y'all hold my beer & watch as tap into this big tank with my weldin' torch & duct tape ..."

Later
BruceD

Title: Re: O2 issues
Post by ozzy on Aug 5th, 2004, 3:40pm

on 08/05/04 at 00:14:32, CarrieBethRN wrote:
 He also said, "....the tank in your closet!"

Carrie :)


Carrie,

You may want to leave your closet door open or partially open. If by any chance (late night, way too tired) you don't completely close off the regulator or if you have a leak, the closet will become saturated with O2. Proper ventilation is advised...

Be careful.

Ozzy

PS, I know, a dozen idiots people will say "I even smoke while puffing O2, and nothing's ever happened". To those people I say, keep at it, you may even get a Darwin Award!

Title: Re: O2 issues
Post by Jonny on Aug 5th, 2004, 4:08pm
EXCELENT advise, Ozzy!!

........................jonny

Title: Re: O2 issues
Post by Big Dan on Aug 5th, 2004, 4:24pm
Damn straight it was excellent advice...


... I always wait at least 5 minutes before I light up after using the 02...


... lost my goatee in a accident involving some 151 and a lighter and something about me being wasted lighting it on fire while it was on my tounge... details are shaddy...

Anyway.. don't want that happenin' again.

;;D



-Big Dan

Title: Re: O2 issues
Post by Superpain on Aug 5th, 2004, 5:16pm
They put sulfer in NO2 for cars so you can't breathe it. Not so for O2...

Carrie, I'd just buy a couple of welding tanks. Your headaches probably aren't going to go away anytime soon, and if they do, they will be back... So it's really more cost effective to buy the tanks and be prepared for the future. Refills are cheap... $18 for an E tank around here.

And unless your insurance is kicking in, I'd get rid of the rentals ASAP. They are just accruing money as we speak.

Title: Re: O2 issues
Post by alleyoop on Aug 5th, 2004, 10:06pm

on 08/05/04 at 17:16:47, Superpain wrote:
They put sulfer in NO2 for cars so you can't breathe it. Not so for O2...

Carrie, I'd just buy a couple of welding tanks. Your headaches probably aren't going to go away anytime soon, and if they do, they will be back... So it's really more cost effective to buy the tanks and be prepared for the future. Refills are cheap... $18 for an E tank around here.

And unless your insurance is kicking in, I'd get rid of the rentals ASAP. They are just accruing money as we speak.


'Nuff said.......................................

................................................alley



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