frustrated with insurance

[nryan34]

Hello everyone, Today is not a good day. I recieved my pump in the begining of March, but insurance still is proccessing it, i mean come on how long does this take! I recieved my second set of three month supplies last week and I just looked on my insurance website and they recieved the bill for them two days ago and they paid their portion of what they are going to pay today. I mean it has been proccessed. So I know exactly what my cost is for my supplies but I guess what I am wondering is has anyone had it take such a long time for a pump claim to be proccessed. Any input or suggestions would be appriciated.

thanks now I just hope my day will get a little better.

Meredith:mad:

[Blue Knight]

Hang in there. I received my pump over 16 months ago and my health insurance just paid the for it last week, leaving me to pay for the remaining 10% of the balance due, so I can understand your frustration. :(

[kgm0612]

Meredith.............what insurance do you have and have you tried calling them? My pump was processed & paid for immediately and before I met with the pump trainer. Maybe it's possible your insurance company paid for the pump in full.

Karen

[pegasus]

It would also be worth calling your state insurance dept; they should have either a complaint line, or an "advocate general," or an "inspector general"--there's all sorts of euphemisms for departments that are supposed to help insurance consumers. Also your state legislature should have insurance committees, and it neverr hurts to write the insurance company and cc the insurance commissioner and the heads of the legislature's insurance committees--and your local legislators. I know this sounds remote and bureaucratic, but there's an occasional good guy out there, and you never know which one you're going to hit.

If you want to do some deeper research, there may also be some history on late payments and what insurance comps are required to do. That's happened in NY, and I think there are some regulations on it now.

Good luck! ;)

PS: And here's hoping your day gets better too!:cheers:

[nryan34]

Karen, I have bcbs of IL and I call them every other day to ask if they have all the info they need and they tell me they think so but the claim is up in review. I wish they they were going to pay for it 100%, But I believe they are only covering 80% cause I have already begun making my payments to minimed for my portion. Thanks soooo much for your input any help is appreciated.

Meredith

[JediSkipdogg]

Why have you made any payments? If your insurance does somehow agree to pay 100% you may not get any amount back. I have around $200 sitting in an Animas account as a credit. It's been sitting there for over 3 years now from when I traded my last pump in. I can't get the money back and my supplies are covered at 100% now, so my money just sits there.

Personally, for me, I'd let it go. The longer it takes them the longer I can save my money. I'd just make sure that you don't spend any of it and just set it aside.

[pegasus]

I initially got a letter from Oxford saying they needed more info (I think from my doc; I'd have to go back and check) w/in 45 days; I called Minimed, and they said it was a crossed wire, that Oxford had all they needed. And I called Oxford and it had been taken care of. This was all, I think, w/in about a month of when I put in my order w/MM. So I wouldn't pay anything until you're clear about what it is you owe after insurance pays and your copays are covered properly etc. Check the deductibles, percentages, usual and customary, etc., before paying. They are very good at screwing up -- and usually not in our favor! :D

[Scarlett]

As Bruce Willis said, "Welcome to the party, pal"

I'm still getting $0.00 bills from MiniMed and I've been off the pump for almost 2 years - ordered some tape covers for the set site and paid for them - now they can't stop the invoices!

I've given up hope on insurance since our deductible went up and their portion went down- we were at 80-20 and now it's 75-25

Let's not talk politics here now either!