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        Daily Chat >> General Posts >> ya ready for this sh*t?
        
(Message started by: PollyPocket on Feb 6^th, 2008, 6:39pm)

Title: ya ready for this sh*t?
Post by PollyPocket on Feb 6^th, 2008, 6:39pm

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. >:(

Title: Re: ya ready for this sh*t?
Post by Gator on Feb 6^th, 2008, 6:51pm

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.

Title: Re: ya ready for this sh*t?
Post by chewy on Feb 6^th, 2008, 6:51pm

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.

Title: Re: ya ready for this sh*t?
Post by brewcrew on Feb 6^th, 2008, 8:50pm

on 02/06/08 at 18:51:43, 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.

Was I right? Did you start feeling better around day 3? How you doin' now?

Title: Re: ya ready for this sh*t?
Post by chewy on Feb 6^th, 2008, 8:57pm

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.

Title: Re: ya ready for this sh*t?
Post by Jonny on Feb 6^th, 2008, 8:58pm

Jen baby, all you need is a weekend with me and you will be a whole new woman (just a little more happy)

;) :-*

Title: Re: ya ready for this sh*t?
Post by PollyPocket on Feb 6^th, 2008, 10:04pm

on 02/06/08 at 20:58:37, 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)

;) :-*

I'm buying the ticket on Friday ;)

Title: Re: ya ready for this sh*t?
Post by purpleydog on Feb 7^th, 2008, 5:55pm

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.

Title: Re: ya ready for this sh*t?
Post by PollyPocket on Feb 7^th, 2008, 6:15pm

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.