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Re: [IP] Pacificare Insurance

At 01:37 AM 9/9/99 -0400, you wrote:
>Hi.........my employment 
>has a horrible HMO...Pacificare.....who won't even pay for more then one
>box of strips a month......has anyone dealt with them as far as getting 
>authorization and covering the pump and supplies??......any suggestions or
>helpful hints in dealing with them would be MUCH appreciated....

I am sure that you have thought of this but my insurance will not authorize
any departure from "standard usage" without a doctor's script or letter of
authorization.  I am willing to test many more times a day than the
insurance wants to pay for.  When I asked for test strips to support ten
tests a day (on average) I was told I was out of line and sent less than I
requested.  Of course the secret is persistence and tenacity.  After having
my Doctor communicate that he wanted me to test ten times daily they caved
and I got the strips.  I still get resisted when placing orders now and
then but (for the most part) the doctor's orders overrode the limits of the
insurance company.

There is one small problem here.  Doctors who consistently "overspend" when
treating their patients are dropped from the list of available doctors and
a new, more compatible, doctor is assigned.  It is in the doctor's best
interest to toe the line.  Not good for the patient!

Bob Blakely
email @ redacted  

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