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Re: [IP] Merk-Medco

 She needs to 
> escalate the problem to the appeals level or above to get results. 
> What the insurance companies count on is that their subscribers will 
> be too meek or too worn out to do this -- thus they don't have to 
> pay. It's the same old song -- be a pest, be a pest, be a pest. Dont'
> take no for an answer.
> email @ redacted
> ----------------------------------------------------------

I agree 100%!  I fought this fight several years ago with BCBS Federal.
 The Rx group said the sets and reservoirs were durable medical, the
Durable Medical group returned every claim to be submitted to Rx
because the equipment required a prescription.  They also required all
sorts of special notations made by me for each claim.  After stressing
about this for several months, I called the main help number and asked
the CSR to tell me what to do.  Instead of letter her/him make me call
the other group, I gave them my number and insisted they call the other
(RX) group.  I had to go a supervisor or two up the line before I found
someone who would do this.  I took down every name and let them know I
was doing so.  The supervisor made a conference call with me and the RX
people and settled it--I thought.  The next claim got the same run
around and I called again, but with FEELING!  I began with my list of
names and went up the system until I got someone who made a note of
this in my records.  I haven't had a problem since.  

Hang in there and keep fighting.



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