Wading thru the muck... You aren't kidding!!

Mikesus · Post by **Mikesus** » Tue Mar 22, 2005 5:44 pm

Well got a call from Anthem bout my reimbursement. Because Cpap.com is located in Texas, they have sent my claim from VA to TEXAS. The reasoning behind this is to determine if they are in or out of network. I explain to them that they are out of network and they do not accept insurance. They say, sorry, its policy.

Well, I explain that this is the 4th time that I have sent this claim in. (they claim to have never have received it) They say that they will look into it...

Well get a call back and it turns out that the other claims weren't lost, they were sent to TEXAS!! So they then proceed to tell me that there is a 20 day period to wait after they send off the claim to TEXAS to wait for a reply. Thankfully they see that it was in fact sent there, and of course TEXAS doesn't bother to respond. So, now they can reimburse me...

What a run around!!

LDuyer · Post by **LDuyer** » Tue Mar 22, 2005 6:21 pm

Gee. Sure seems like an awful amount of muck you're wading through!

wading thru the muck! · Post by **wading thru the muck!** » Tue Mar 22, 2005 7:20 pm

Mike,

That's exactly what happened to me and to top it off, when they finaly issued a check they sent it to cpap.com. I don't know how these guys find the door out of the building to get home at night.

Mikesus · Post by **Mikesus** » Tue Mar 22, 2005 7:23 pm

Well, she insists that she knows that I paid for it, and I should be reimbursed... We shall see...

wading thru the muck! · Post by **wading thru the muck!** » Tue Mar 22, 2005 7:40 pm

My claim was accompanied by my invoice market PAID IN FULL. Lets hope your's is not misdirected on it's way to you.

HEY GUYS! I CAN'T FIND THE DOOR!

Janelle · Post by **Janelle** » Wed Mar 23, 2005 1:28 am

Then there's the DME who didn't send the Letter of Medical Necessity to the Insurance with the claim for the equipment. How dumb can you get? You'd think they would know these things.