It's been a month and a half since Justin was fitted for his helmet. A few weeks ago I received a letter from my insurance company stating that my claim may be denied if they didn't receive additional information from the doctor. So I called Wright & Filippis to see if I needed to do anything and they told me that they were handling it and had already requested additional documentation from the doctor. I mentioned that Justin also had Medicaid to see if they tried to bill them but apparently they're still showing that Justin is covered under Carl's insurance, which was discontinued last year. They told me that I need to contact my Medicaid case worker to have them change that information in the system, which would be fine if I knew who that was. I had to call Justin's social worker from the NICU to find out who I needed to contact and she gave me Justin's case number and other pertinent information. (Side note: One would think that this is something I would've received shortly after Justin's birth, but no, I got nothing. One day an insurance card just appeared in our mail). Anyway, I just received that contact information but haven't had a chance to call yet. Besides, when I talked to the doctor's office they told me that they had written a letter of medical necessity so I thought I would be covered. Apparently not.
Two weeks have passed and still no news, so I called Wright & Filippis today and I'm told my insurance denied the claim. Okay, was anyone going to tell me. I'm so frustrated with the customer service in the health care industry. I should've been informed in the beginning that they won't start making the helmet until they have insurance approval. That way I could've been more on top of things, or maybe we could've paid out of pocket and then submit a claim to our insurance for reimbursement. Now I have to deal with the Department of Human Services, which I've heard can be really slow. I've already called 5 times and can't seem to get anyone on the phone. Looks like I'll be making a trip to their office first thing tomorrow morning.
We've lost a month of treatment, and I'm frustrated because we're missing the optimal time to see the best results.
Thanks for the update; I had been wondering what the status of the helmet was.
ReplyDeleteugh. that is frustrating. insurance companies do all they can do NOT to pay out for things.. it's unfortunate because that's what we have them for - to pay out for things. i hope you get it worked out. keep us posted.
ReplyDeleteAs if you didn't have enough on your hands, without resorting to a lawsuit!
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