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Title: O2 & Insurance Companies Post by Sylvan on Dec 22nd, 2004, 5:06pm Does anyone have any advice on actually getting an HMO to approve O2 for CH? So far - My insurance company has had my Neuro fax a letter of medical necessity to the O2 contracter which then has to submit the request to the insurance provider for autorization which i am told can take from several days to several weeks. Then - IF it is approved i will get it. Otherwise - my doctor needs to appeal the denial and start the whole mess over again. I'm seeing this taking months to get sorted out - if ever. How much do ya wanna bet i'm out of cycle before i even see the O2? Anne |
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Title: Re: O2 & Insurance Companies Post by EvertBoer on Dec 22nd, 2004, 5:38pm I had the same problem. However, I just paid for the oxygen and the rental. Eventually, the Insurance company agreed with the doctor and paid. However with each claim, I had to have a photocopy of the original oxygen prescription to avoid delays. If you can afford it (and oxygen is not that expensive), start using it and get reimbursed later. |
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Title: Re: O2 & Insurance Companies Post by Mr. Happy on Dec 23rd, 2004, 3:33am Insurance will NOT approve O2 for me. Period. So I pay for it myself. That's OK...it's not That big an expense. Although I haven't had to use them much, the insurance company gladly foots the bill for thousands of dollars of Triptans over the last few years. They're idiots, RJ |
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Title: Re: O2 & Insurance Companies Post by marlin on Dec 23rd, 2004, 5:35pm I had no trouble at all. Aetna has a preset agreement with a local oxygen supplier. All I needed was a prescription and the Oxygen supplier took care of it just like a pharmacy would. I had it delivered within 2 days. Like RJ says, the trex is a lot more costly and then there's the ER visits... WHo's your ins co. I need to stay away from them when my renewal comes up. |
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Title: Re: O2 & Insurance Companies Post by Sylvan on Dec 23rd, 2004, 9:08pm on 12/23/04 at 17:35:33, marlin wrote:
Cigna Health Care - *sigh* Oh how i miss Aetna. Or even the Blue Cross Blue Shield I had many many years ago. Employer funded HMO's are the pits. Just got a call from my doc - they tried to pre-certify my MRI - and the hospital where my Neuro is affiliated with will not do MRI's for Cigna. Actually worked out ok though - i'll be going somewhere much closer to home that has open MRI. Sylvan Sylvan |
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Title: ode to O2 Post by rumplestiltskin on Dec 23rd, 2004, 11:15pm keep pumpin the paper work to em and they will eventually cover it. They may ask fer more than seems reasonable...twice...butt keep at them. Mr Happy is too dumb to figger it out and yet...as I discovered ...the idiots may choose to rent tanks and then add the cost of the refills at exorbitant med supply house prices...and yada yada yada...the copay ends up more than just gettin the shit yerself from the welding supply house...the only satisfaction I derived was teachin a bunch of folks about clusters. and yet...yer ins co. may cut a better deal...so be patient and keep those faxes, letters, and phone calls comin. Wage Peace den |
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Title: Re: O2 & Insurance Companies Post by Sylvan on Dec 27th, 2004, 1:59pm Guess I gotta laugh - Insurance approved it without a hitch - except the Dr wrote out the RX to the supplier for a small portable tank with a cannula instead of a mask and only 3 liters per minute capacity! The woman at the supplier is sending me the mask - and contacting the Dr to re-write the RX - she told me that for cluster you need like 10 liters/minute and that the supply would run out in about 5-10 minutes at that rate from this tank. She's contacting the Dr to get the correct liter flow RX and get me the correct equipment. Never a dull moment. |
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