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Re: [IP] Insurance Woes

I don't know if this applies, but here goes.

I work for a government contractor that also uses Blue Cross Blue Shield of
Mass.  When you call up and ask them questions or report a problem, they
give you a reference number for your call, which is recorded.  It is
important to write down this number and the persons name you talked to.
This protects you from them going back on their work.  In Mass. if you call
and the representative on the other line says they cover it, then they have
to cover it. I have reference numbers for three different people who said
that they cover pumps, pump supplies, and any hospital time incured while
getting on the pump.  Not sure about that last one, but their webpage says
they cover the first two.  But since the representative says they do...they
will. :-)

i am sorry to hear of your problems.  Sometimes you just have to put a foot
down (no pun intended...honestly) and get some results.  Keep calling, and
calling, and calling.  Often they will approve things just to get you off
their back.

Best of luck,
-----Original Message-----
From: email @ redacted <email @ redacted>
To: email @ redacted <email @ redacted>
Date: Monday, June 21, 1999 10:05 PM
Subject: [IP] Insurance Woes

>I'm having all kinds of problems with the insurance company and the doctor.
>Perhaps someone has some advice.
>I'm a federal employee and have Blue Cross.  In April, I went on vacation
>did a lot of walking.  My foot became very red, hot and swollen.  I went to
>the doctor and he wanted to put an una boot (special type bandage) and
>walking cast on it.  My leg was so swollen that I weighed an extra 10 lbs.
>Walking was very difficult and painful.  Blue Cross said the doc would have
>to send a letter in for predetermination and BC would decide on it.  A week
>of extreme discomfort passed and nothing from Blue Cross.  I called them up
>and said that one way or the other, I was having the treatment.  They
>to let me have it, with the understanding I would have to pay ($200) if
>did not cover.  The first letter the doc sent in, he neglected to mention
>diabetes.  Needless to say, it was not covered.  He sent it in again and
>mentioned my diabetes, and still it is being denied.  The una boot
>helped tremendously with the swelling as did the cast.  I can't believe
>are quibbling over such a thing.  If this had continued to go, I feel sure
>would have ended up in the hospital with an infected leg.  I wrote a letter
>to complain to Blue Cross, explaining the situation in detail.  They then
>told me they could not do anything until the doctor filed the claim.  I
>called the doctor's office and they are going to file the claim, but now BC
>is telling me that it will be denied since Medical Review has already
>this service.  I plan to file an appeal once it is denied; however, I am
>feeling very frustrated.  In addition, since all this, I have been
>with Charcot's Foot.  I've ordered a pair of diabetic shoes.  These are
>something I will have to have the rest of my life.  The initial claim for
>them has also been denied.  I'm not sure what the problem is, but I've been
>told by BC that they cover them.  I'm getting very weary of insurance
>hassles.  Any suggestions would be welcome.
>Anyone else that is a federal employee, what type of health insurance do
>have and are you happy with them?  How do they pay regarding pump supplies?
>I'm wondering if I should change insurance companies when I get the
>Thanks in advance.
>Insulin Pumpers website http://www.insulin-pumpers.org/
>for mail subscription assistance, contact: HELP@insulin-pumpers.org

Insulin Pumpers website http://www.insulin-pumpers.org/
for mail subscription assistance, contact: HELP@insulin-pumpers.org