On Wednesday the insurance company informed me that Marie's current chemotherapy treatments would be denied. Even though the oncologist wrote a letter saying this is medically necessary, the insurance company has denied the treatments. I asked to talk to the medical director at the insurance company, but i was denied access. I was told that I wasn't on his level.. Marie's doctor could call and request a peer to peer discussion, but I can not.
We are supposed to follow the appeal process. The insurance company is sending a letter of denial that should describe the appeal process. Wow, I can't wait.
The best part for the phone call on Wednesday from the case manager at the insurance company. She left me a phone message, to call her, and to have a great day. That's right. She wanted me to have a great day, even though she knew she was going to tell me, that they were not going to pay for the treatments, that the oncologist prescribed.
I have been on the phone, constantly, with doctors, nurses, and financial managers. The financial managers are the ones that work with the insurance companies.
I can't believe a company would say, "Sure, go ahead we'll cover it." And then two weeks later say, "Oops never mind, we forgot that this costs a lot of money. So you get the bill." What exactly are we paying for with our insurance, the right to be denied? Please, reject us because we don't have billions of dollars!
ReplyDeleteI just 'LOVE' those BS responses!! 'Have a great day!!' Unbelievable!!! Sooo out of touch!! So insensitive!
ReplyDelete~Michelle