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| | #1 (permalink) |
| Registered User | one the issue of not having insurance..I have it and they still didn't cover anything. I mine as well have saved my money and paid out right. My blood work that they did to check for pcos cost over $1000. My insurance won't pay because they say they are like maternity test and they don't cover maternity. I'm very upset. |
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| | #2 (permalink) |
| SoulCyster #1 Join Date: Nov 2000 Location: Los Angeles, CA ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Hmmm, I'd fight that one...
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| | #3 (permalink) |
| Mikes Girl Join Date: Sep 2006 Location: Waco, KY ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | I am with Kat- I def fight that!!
__________________ Kellie & Mike To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. Together for 13 years Married 9/3/05 TTC since with 1700 MG Met 1 Angel Baby @ 5 weeks 2 days 4/22/07 To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. BFP on 01/17/2008 (met only) PRAISE GOD!!!! 1/30- sac seen Its a GIRL!!!! Lauren Elisabath is on her way!!! To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. |
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| | #4 (permalink) |
| SoulCyster #1 Join Date: Nov 2000 Location: Los Angeles, CA ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Also, why was your doctor running 'tests for pcos'? Why weren't they running tests for Cushings, etc? That's what should have been noted in your files...not suspected pcos... PCOS is a diagnosis of 'exclusion', so the 'tests' should really be part of looking for something 'other than' pcos...
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| | #5 (permalink) | |
| Registered User Join Date: Mar 2008 Location: Mississippi ![]() ![]() | Quote:
Good luck!
__________________ Diagnosed 3/2008 Meds Spiro 100mg Met 500mg & increasing Yaz “According to a recent survey, men say the first thing they notice about a woman is their eyes, and women say the first thing they notice about men is they're a bunch of liars” | |
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| | #6 (permalink) |
| Registered User | thanks f or the advice I'm going to talk to my husband and see what we can do. I'll let you know if anything changes. |
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| | #7 (permalink) |
| JosieFB Join Date: May 2006 Location: Nashville ![]() ![]() ![]() ![]() ![]() ![]() | Have your doctor re-file and note that it is to check for an endrocine disorder and/or a metabolic disorder. If he really ran a full panel of blood tests to diagnose PCOS, he checked your blood lipids. PCOS causes problems far beyond being unable to conceive including cardiovascular disease. |
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| | #8 (permalink) |
| Registered User | 1 - Your plan provides benefits for covered expenses at the plan's recognized percentile level of charges received by Aetna for the sameservice. If there is additional information that should be brought to our attention, please let us know.2 - You are covered for expenses at a level set by your plan sponsor. The charge for services exceeds that amount. You are responsible for theamount indicated. If you have additional information we should consider, please let us know.3 - This charge is considered a maternity charge as described in your plan of benefits. Maternity charges are excluded from coverage under yourplan. This is exactly what they gave as reason for not covering. I'm not sure what the first two mean. No percent was shown nor do I have a level set by a plan sponsor.?? |
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| | #9 (permalink) |
| SoulCyster #1 Join Date: Nov 2000 Location: Los Angeles, CA ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Your doctor screwed up (big time) when s/he entered the code(s) for the tests.
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| | #10 (permalink) | |
| Registered User Join Date: Mar 2008 Location: Mississippi ![]() ![]() | Quote:
They can use 626. _ _ for disorders of mestruation, 704._ _ for Obesity, 704.1 for hirsutism and so on. The best people to talk to at the office is the billing and coding department. 256._ is PCOS diagnosis and should not be used unless every other possible diagnosis has been tested for. The doctors office may need to file a corrected claim with medical records to back it up and it wouldn't hurt to do appeal and have all the information ready in case they deny it or it comes up in your insurance history later on.
__________________ Diagnosed 3/2008 Meds Spiro 100mg Met 500mg & increasing Yaz “According to a recent survey, men say the first thing they notice about a woman is their eyes, and women say the first thing they notice about men is they're a bunch of liars” | |
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| | #11 (permalink) | |
| SoulCyster #1 Join Date: Nov 2000 Location: Los Angeles, CA ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Quote:
FYI: Website that advises and advocates on behalf of those with chronic conditions
__________________ To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. COMING SOON - The *New* Soulcysters! - CLICK TO READ!! To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. Last edited by KatCarney : 04-21-2008 at 10:27 PM. | |
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| | #12 (permalink) |
| I Am Iron Man Join Date: Oct 2003 Location: Alabama ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | I'd fight anything the insurance says they won't cover. I speak from a lot of experience. They were always putting in the wrong codes for tests and procedures. Sorry this happened to you. Good luck with your appeals process.
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| | #13 (permalink) |
| HI all | wow... that is not right you need to fight.... i think they messed up on your codes i agree with all of the above
__________________ To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. Medicines: Proventail inhaler (asthma) (NOTE: i am still waiting on a DX) |
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