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Re: [IP] Doctors at HMO's

     Guess this explanation makes it easier to understand why Melissa's adult 
endo gave up his very busy practice & went to work for Pfizer!!!...and why my 
equally busy former internist gave up his practice....sad, sad state of 
    As to the resolution of claims' issues, I made myself such a "thorn in 
their side" that I was able to circumvent the usual chain of command & now 
send our claims directly to the "head honcho" of Human Resources at my 
husband's parent company. Interestingly, having made such a pest of myself, 
the insurer ( out of state) made arrangements with our pharmacy & our 
physicians to bill them directly (despite Humana not being recognized here in 
PA) which cut down on my claims by about 90%. At one point, things were so 
horrifically botched, that I was OWED the $6000 we'd paid out of pocket for 
my neupogen shots ( 10 shots=$2000 X 3 cycles) to restore my white counts 
destroyed by chemo. An ironic twist of fate by the way to have Melissa giving 
ME shots!!!
    Bottom line- PERSISTENCE!!! We also had 16 out of 20 prescriptions 
"rejected" once for not having the "required info" - all of which was clearly 
marked on the slips submitted! My nasty note to the "head honcho" about how 
they were paying this insurer for gross incompetence in addressing their 
employees legitimate claims may have "done the trick"!!! LOL...

Regards, Renee ( Melissa's pump-mom)
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