Posted by gary g (208.133.220.153) on December 15, 1999 at 20:05:50:
In Reply to: Another call to action? posted by Ted on December 15, 1999 at 18:25:35:
Thanks Ted,
it's not near that point yet
I was just "alerting" folks to keep their eyes open, especially in view of the Imitrex/insurance discussion running here lately
just because we make progress in this area, doesn't mean we don't have to keep at it -
as for my case, at this time, it is no problem to me-
in fact, I'll be paying for this anyway because my deductable won't be met by year's end anyway...
I'm very grateful that for relatively minor things such as the oxygen, I can "front" the expenses & argue with the insurance Co later,
so I don't go without
Besides:
they haven't said NO actually
they've said "we can't approve it until........"
and then added a bunch of nuisance requirements, that mean I have to reconstruct a lot of documentation I've done a dozen times already,
and further bother my very busy, not rich, very helpful doctor for more of HIS time to duplicate verifactions & prescriptions he has issued before without challenge
Drummer -
I AGREE with the need for regular reverification of ANY prescription, absolutely, for ALL the reasons you listed
actually I'm pretty hardass about that I guess,
to me, using insurance pool money for viagra, vanity-based plastic surgery, etc (as opposed to trauma reconstruction, major birth defect correction etc)is BULLSHIT-
a month ago I bought a $250 therapy lamp to experiment with, and didn't even THINK about hitting them up for that.......
BUT
I DO NOT agree with the necessity of being repeatedly put through the wringer by the same insurance company that has covered me since 1971, having to prove I have the disease which they have ALREADY paid to have diagnosed by SEVERAL docs over that time - ALWAYS the same result:
"episodic cluster headache with no other apparent neurological or vascular affliction"
this isn't a case of due diligence - it is outright obstructionism of the type designed to get people to throw their hands up & say "to hell with it, I'll just pay the damn bill myself".
Which takes us back into the general medinsurance debate -
which is much much bigger than CHMB
ONE INTERESTING SIDENOTE -
this company, a BC/BS unit,is now engaged in public hearings, etc, to sell itself to a for-profit outfit called Anthem
so I'm sure they're in the middle of a big puff act to show how "on top" of things they are