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RE: Kicka, part 3 - 3/14/2008 11:13:18 AM
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TammyIsBlessed
Posts: 1642
Status: online
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Welcome Chelsea!!!
I know - I had to skim most of this thread it exploded so fast!
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I am only one, but still I am one. I cannot do everything, but still I can do something. I will not refuse to do the something I can do. Helen Keller
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RE: Kicka, part 3 - 3/14/2008 12:20:02 PM
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PrincessDonna
Posts: 10436
Joined: 4/11/2005
From: Cow country, Upstate NY
Status: online
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Thanks for the update, Jeanie!
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<<-----------Brian + vacuum= sexy man!! 
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RE: Kicka, part 3 - 3/14/2008 12:34:48 PM
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RepentanceIsRequired
Posts: 1111
Joined: 9/14/2005
From: Home is where the heart is.
Status: offline
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quote:
ORIGINAL: Bubbles5
Nicole,
I TRYED reading our new policy. It went right over my head 
Altho I am being more responsible in calling ahead of time to see if a procedure is covered. My mamogram was suppose to be covered 100%. But after 3 months I got a bill. I called my ins. company to see what happened. After about a half an hour purshing this number, and that number, and being put on hold. I FINALLY got to talk to a real person!
They assured me the check is being sent out soon to the hospital. Same thing happened when I got my cholonosopy (sp?) I don't know if they paid that or not. Altho they said they would cover it 100%. Guess I should call the hospital and see if they ever got their check.
See, my last insurance company never had me do all this checking.
Oh yes, I understand what you are saying. I have stepped up to bat for many people because of the way a procedure was coded. For instance like you mentioned with the mammo or the colonoscopy, an insurance will pay differently if it is coded by the hospital as a screening or a diagnostic. With most plans they will pay once a year for a screening as part of your annual exam. Diagnostic however is when the patient has had a procedure and "something" was found and thus warranted something more invasive like a colonoscopy vs sigmoidoscopy. But then where we (more like I in battling with the ins) have issues is when I would call up the UR nurse to tell me how it was coded she would say that per the drs notes it was coded as a diagnostic not a screening, well that is how we have to code it. Then on the flip side we have the patient hollering that no, it was a screening. Well unfortunately we can't go by what the patient says, once it is written/transcribed by the dr, that's what goes. Thus we have billing issues.
Okay, I don't know if you really wanted to know all that, but there you have it.
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--Nicole--
If you want to make God laugh, tell Him your plans.
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RE: Kicka, part 3 - 3/17/2008 4:12:30 PM
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TammyIsBlessed
Posts: 1642
Status: online
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She hasn't logged in since Friday, so I'm hoping so!!
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I am only one, but still I am one. I cannot do everything, but still I can do something. I will not refuse to do the something I can do. Helen Keller
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RE: Kicka, part 3 - 3/17/2008 5:54:25 PM
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Mrs.Wifey
Posts: 5088
Joined: 4/12/2005
From: The Gorgeous plains of Colorado
Status: offline
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Me too!
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RE: Kicka, part 3 - 3/17/2008 6:10:18 PM
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Bubbles5
Posts: 1009
Joined: 4/12/2005
From: Wisconsin
Status: offline
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Oh my...now we have to wait and find out.
I better mail out the baby quilt, and fast..........
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Avatar of my dad and his five daughters
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RE: Kicka, part 3 - 3/17/2008 9:34:24 PM
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magdaleine
Posts: 5178
Joined: 4/11/2005
Status: online
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I just found this thread. Jeanie, I've been wondering why I never see you in CW anymore. Now I know. You spend your time HERE! I'm going to try this out for a while. If it moves too fast I'll have to unsubscribe but I'll give it a go.
When did you announce your pregnancy? And already you're overdue (or maybe given birth)? Wow. Time flies. I hope you're doing well.
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Maggie
Ask me about my book. It's now available online!
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