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Insurance denial...
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<blockquote data-quote="ksm" data-source="post: 484367" data-attributes="member: 12511"><p>We have had this insurance policy since we adopted the DGD's. It was not a state adoption, but a private adoption, even though they had been in custody of the state for 2+ years. It is not medicaid - but a policy we pay for based on our income. We could put them on our family policy - but it has been cheaper to not add them because of the copays for visits, rx, glasses, dentist. If we add them - we lose the state children's insurance. </p><p></p><p>Last year, I had a problem with getting them to pay for easy child's glasses. When I went to purchase them, we were told we didn't have coverage. I went home, found my letter saying our insurance had been approved for one more year. Called the ins company and was told, oh, it was just a computer glitch, we have had no loss of coverage. Well, we got the glasses, but then they didn't pay for them for 4 or 5 months! The eye glass shop kept getting denials that we weren't covered for the date we got the glasses! </p><p></p><p>I made many calls, and hunted on the website for the insurance until I found real people with email's and started contacting multiple people. I kept getting told it was was all taken care of. But the glasses never got paid for. I finally called the State Insurance Commissioner's office and was told they could only help with problems for private insurance... not state insurance!! </p><p></p><p>I was persistant and finally got it taken care of -but I was MAD! I would guess that the majority of people with state insurance would not have taken the time and persevered to get it taken care of and would have paid out of pocket for things the ins company was legally liable for.</p><p></p><p>I have worked in medical offices and did medical coding for diagnosis and procedures, filed insurance, posted insurance to accounts, and made numerous calls to get things precertified. I know the language and what is covered and will push. But right now I will wait and see what the neuropsychologist can do on her own. </p><p></p><p>KSM</p></blockquote><p></p>
[QUOTE="ksm, post: 484367, member: 12511"] We have had this insurance policy since we adopted the DGD's. It was not a state adoption, but a private adoption, even though they had been in custody of the state for 2+ years. It is not medicaid - but a policy we pay for based on our income. We could put them on our family policy - but it has been cheaper to not add them because of the copays for visits, rx, glasses, dentist. If we add them - we lose the state children's insurance. Last year, I had a problem with getting them to pay for easy child's glasses. When I went to purchase them, we were told we didn't have coverage. I went home, found my letter saying our insurance had been approved for one more year. Called the ins company and was told, oh, it was just a computer glitch, we have had no loss of coverage. Well, we got the glasses, but then they didn't pay for them for 4 or 5 months! The eye glass shop kept getting denials that we weren't covered for the date we got the glasses! I made many calls, and hunted on the website for the insurance until I found real people with email's and started contacting multiple people. I kept getting told it was was all taken care of. But the glasses never got paid for. I finally called the State Insurance Commissioner's office and was told they could only help with problems for private insurance... not state insurance!! I was persistant and finally got it taken care of -but I was MAD! I would guess that the majority of people with state insurance would not have taken the time and persevered to get it taken care of and would have paid out of pocket for things the ins company was legally liable for. I have worked in medical offices and did medical coding for diagnosis and procedures, filed insurance, posted insurance to accounts, and made numerous calls to get things precertified. I know the language and what is covered and will push. But right now I will wait and see what the neuropsychologist can do on her own. KSM [/QUOTE]
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