Frustration w/ Doc & Insurance

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
teach33

Frustration w/ Doc & Insurance

Post by teach33 » Wed Feb 29, 2012 6:29 pm

I read somewhere on here that you should not sign the release of all medical info, but rather call the insurance company first. I had already signed a week ago tomorrow when I read that! I did call insurance company yesterday morning. DME that got info finally called this afternoon saying they were not in Network on my insurance and at least were understanding that I should go somewhere else. Insurance yesterday gave me a # to have doc fax prescription. When I called nurse after talking with DME this afternoon, she wanted me to sign forms again. I said I didn't understand why as insurance had already paid for sleep study. I think she was going to fax prescription, but probably not until tomorrow. I feel like I'm getting the run around. Haven't had a good night's sleep in a long time- finally found a solution and can't seem to get it! Is this normal procedure?

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hades161
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Location: Wisconsin, USA

Re: Frustration w/ Doc & Insurance

Post by hades161 » Wed Feb 29, 2012 6:33 pm

The process can be annoying for sure. I am not an expert in Insurance Claims but I have found these links helpful

https://maskarrayed.wordpress.com/what- ... me-part-i/

This one too.

http://adventures-in-hosehead-land.blog ... -with.html

and lastly this one is good as well

https://maskarrayed.wordpress.com/2011/ ... -machines/

I hope things go well for you and wish I could help more.

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Janknitz
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Re: Frustration w/ Doc & Insurance

Post by Janknitz » Wed Feb 29, 2012 6:58 pm

Insurance yesterday gave me a # to have doc fax prescription. When I called nurse after talking with DME this afternoon, she wanted me to sign forms again.
There is a strict patient privacy law called HIPAA--Health Insurance Portability and Accountability Act. Your doctor or any medical provider faces stiff fines if they release your medical information without your SIGNED written consent. So you may have signed forms for DME #1, but now they need to send the prescription to DME #2 and so far you have not signed a form authorizing your doctor to send the prescription to DME #2.

It's a PITA, but it's meant to protect your privacy. These things are out of your control, so you have a choice--you can either let them drive you nuts or just go with it.

Make sure you get a copy of the prescription IN YOUR HAND. If you are not happy with DME #2, you can look for another network DME provider you'd rather do business with. It's harder to have that control when you don't have the prescription in your own hand and you have to go through all this rigmarole AGAIN if you decide to take your business elsewhere.

Be a careful health care CONSUMER, don't leave your fate in the hands of others.
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BlackSpinner
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Re: Frustration w/ Doc & Insurance

Post by BlackSpinner » Wed Feb 29, 2012 7:33 pm

Walk into the doctors office and get a copy of your own. Then get the list of the in network DME's and go down the list and interview them. Make sure that they will provide a fully data capable machine without charging you extra. Find out what masks they provide and how experienced they are in fitting masks, ask for references.

Like buying a used car, be aware of the con artists out there and take a reliable friend or at least a check list along with you.

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