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Re: Anybody Having problems with there insurance & PCOS

From: Dona (anonymous@obgyn.net)
Tue, 2 Oct 2001 22:19:53 -0500 (CDT)


That sounds really bizzare Patrick. What Insurance company do you have? I have Aetna PPO through my husbands employer and they have paid for everything so far,including ultrasounds and my Glucophage.Does your employer have open enrollment periods with options to change insurances? maybe you can change insurance carriers in Jan. to a better plan or discuss with your or your wives employer that the insurance he is providing is not a very good one...maybe they will change companies.Worth a try. If you pay for insurance yourself I would definately look into a different plan.Did your Doctor write a report for the insurance company as to why he wanted to do these proceedures ..sometimes that helps He would have to write this and send another claim. Also your wifes Doc should have done a pre-authorization before doing any costly ultrasounds or proceedures to be sure the insurance would cover. My RE's Nurse called my insurance before they did anything to make sure I had benifits for it.You might just have to keep calling your insurance and argue it out with them,unfortunately some companies have a policy of deny 3 times then pay.I run into that all the time with Dental insurances at the Dentists office I work at. Good Luck,Dona

>At Mon, 1 Oct 2001, Patrick wrote:
>Hey I was wondering if anybody is having problems with there insurance
>wanting to pay for there treatment in PCOS? My insurance is saying the
>only treatment they will pay for is "having the ovaries scraped". They
>say that according to the AMA this is the only acceptible treatment. My
>wifes OB/GYN has her taking a ton of meds then want two ultra sounds
>done a month. The insurance say this is unexeptable and is considered
>part of prep for invitro. My wife and I can't afford invitro so why
>would we be preping for it knowing our insurance does not pay invitro.
>My wife found out today that we have a $1100.00 bill at our OB/GYN that
>the insurance is denying to pay and the DR office won't let us continue
>until this is settled. If you have any helpful info please HELP.
>
>--
>Patrick J Wensmann
>




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