Anyone have Value Options?

Discussion in 'General Parenting' started by Kathrine, Jul 30, 2004.

  1. Kathrine

    Kathrine New Member

    Because I feel they are trying to get out of paying the claims. I've been on the phone all morning with them, and have gotten nowhere. The psychologist has to talk to them again today, and figure out why they are flatly denying all the claims. My parents have Value Options, and they too have outstanding claims that aren't being paid, for my brother. I was wondering if anyone else has had problems with this company. I'm going to write to my health care provider and try to get them to switch companies for mental health care. It's just been ridiculous.
  2. Marcie Mac

    Marcie Mac Just Plain Ole Tired

    Make a complaint to the Department of Insurance in your state - you can access them on line for the number for the consumer hot line.

  3. bigblueagain

    bigblueagain New Member

    dependent on what type coverage you HMO,PPO or indemnity. There may be a timely filing period that your provider is not abiding by, or the actual carrier may be outside of it for which the insurance dept at your state level should be able to help you. If it is an hmo or ppo, however, they probably have a contract that should forbid the provider from billing you directly. Call the cs dept of the carrier and ask about this.
  4. Fleurdaisy

    Fleurdaisy New Member

    My daughter has Value Options and although the people who you actually deal with trying to get your child in an Residential Treatment Center (RTC) are a royal pain, I never had any problem with getting claims paid. I finally wised up and my daughter's psychiatrist would handle talking them into allowing her admittance so I can't complain too much. But, if the account people are half as stupid as the the intake people, I can see your problem. Another thing that may have been in my favor is that my psychiatrists office manager is the meanest woman I've ever met! She could probably terrorize them into paying claims they didn't even owe!

    Our coverage is so good through Value Options (they paid for an $18,000 a month Residential Treatment Center (RTC) for as long as my daughter needed it!) you may rethink talking the employer out of getting rid of them. Sometimes the devil you know is better than the devil you don't.

    I'm sure Blue's advice is solid.

  5. Kathrine

    Kathrine New Member

    We have had so much problems with them! The office manager at my psychiatrist is a very patient woman. She called them with a question about how many units of counseling sessions they had certified, (This was after the first session) and they told her they never certified anything for my son. She's like "But I've got your letter--I'm holding right here." They didn't believe her! So she had to fax them the letter where they certified so many units for my son. And then they sent me another letter certifying the treatment again. Then, after 4 sessions, I get a bill from the doctor, and no one had ever told me the claims were being denied! ValuOptions said they don't cover what my son has, and I was like, you certified so many hours of counseling, --if you didn't cover it, why didn't you tell me after the initial evaluation? They were like "you should've gotten a letter." Um--no. I don't think so. They're just screwing around with me. Well, I'm still working with the doctor to get this all straightened out. I hope to find out for sure on Monday what's being done.
  6. mose

    mose New Member

    I have Value Options. I remember them being very fussy with getting pre-approval. Speak to the manager or the person who signed the letter or a person who has the authority to make decisions.

    They only covered my daughter for 10 days inpatient at psychiatric hospital per year! (it was pulling teeth to get this from them!!) When my dauhgter needed a longer stay the social worker at the hospital told us we could apply for Medicaid under the "Katie Beckett Bill". We applied in the hospital Medicaid office and she received it.

    In my experience It is usually what blue has described in the docotrs office.
  7. bigblueagain

    bigblueagain New Member

    I'm not really sure what Value Options it an HMo or ppo product? Anyway now that I see you do have a letter that may be your salvation, as they can't deny what is in black and white. If they come back and say there is a disclaimer on it stating it is not a guarantee of coverage, then you may really should go thru the claims or customer service manager. BLUE
  8. LisaG

    LisaG New Member

    The other advice posted here is as good as I can give you. I'm posting because I thought that some of you might be amused to know that Value Options runs the entire state mental health system in Arizona for the medicaid program here, AHCCCS. Believe it or not! :rolleyes: