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[IP] Doctors at HMO's

Hi Dr. Mike,
I ride in your same boat.  Our health insurance for our family practice
group is through a local PPO.  Despite being a *STOCKHOLDER* of the parent
company, I have to fight with the insurance for each and every one of
Jenna's benefits.  In her two years of diabetes, they have NOT ONCE paid the
endo's bill correctly (he is an out-of-network provider, despite the fact
that they don't have any peds endos in-network, and I have the prior
authorization), and denied pump supplies because I didn't have prior
authorization (duh, they approved the pump, what did they think we'd use
with it?).  I think that they just say no because most people don't have the
energy to fight it, so they save a lot of money that way.  And the folks
making the decisions are clerical people, they don't have a clue as to what
the big picture looks like, whether pumps need insulin or tubing, or
anything else.  It is so frustrating, and to all of you out there, it isn't
the doctor's fault!

Nancy Morgan

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