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Insurance says "no", now what?

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Old 12-26-2011, 03:12 PM #21
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Good point Mark56! That will be something I ask when I call them back!
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Old 12-27-2011, 12:28 AM #22
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Hey, Puppyraiser:

Looks like we're from the same neck of the woods. Lived in Orrville and Wooster for many years before moving here down around Columbus. If you want a great pain management dr. I can give you the name of my dr. down here in Columbus. He implanted me with two SCS's at the same time (lumbar and cervical) and I didn't even have to stay overnight at the hospital. He was originally trained at Cleveland Clinic and now has his own practice here. He also teaches other doctors on how to implant them. He a has a psychiatrist that does the psych. evals. for him, if you're interested. I know Wadsworth is a drive, but I drive to Cleve. to see one of my other doctors because I know it's hard to find a good dr. and when you do, the drive is worth it.

Let me now if you want his contact info.

Best of luck and I'll be praying for you

Fiona
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Old 12-27-2011, 08:28 AM #23
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Quote:
Originally Posted by Puppyraiser8 View Post
So here is the latest update...

I spent a lot of time on the phone, but I managed to get some info. :-) APPARENTLY, my psychologist WANTS me to have the trial, but also wants me to have pain management skills at as well. So I guess my insurance company is just being ignorant. BUT, the psychologist I saw is quite a drive away (over an hour) so I'm supposed to try to find someone closer to home. I think some of this is making me wait til the first of the year (deductibles and all that). I'm still pretty mad though because I had to spend several days doing nothing but calling people...several over and over (and some never called me back) just to get answers. And, the idea of trying to find a separate psychologist who doesn't know my case at all is a little daunting. It's either that or drive the long distance to the current one. This involves lots of time and childcare. :-(

SO! I am thankful for all your advice/encouragement. I will keep everyone posted. In the mean time, it's the same old pain junk. But at least my initial evaluator isn't as ignorant as I thought. :-)
If you really believe that they are trying to "get you" with the deductable issue, appeal that as well.
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Old 12-27-2011, 01:39 PM #24
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If you really believe that they are trying to "get you" with the deductable issue, appeal that as well.
I can do that? I don't think I have any proof...I'm just assuming that money is the biggest player here. It makes sense....
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Old 12-28-2011, 09:21 AM #25
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Heart Depends on the size of the deductible
If you have a high deductible insurance plan as we do, well, it could make sense to visit with a lawyer about it, they may suggest some things, BUT going to war with insurance with a lawyer will interject delay most likely.

Initial interviews of this sort are often low cost or no cost to get a feel for your case.

Yup,
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Old 12-28-2011, 11:52 AM #26
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Default Hi puppy raiser
Mark may be right that with a lawyer could slow it up, but I would do it if it were me. Having an advocate to go to bat with you may be worth the delay to get the insurance settled for your benefit. If the Laywer sees the issue, as you do (Its about the bottom dollar) he can be agressive also in your behalf. Just a thought. I sure hope this works out for you. I deal with medicare/medicaid, and sometimes it is not any easier. ginnie
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Old 12-28-2011, 11:08 PM #27
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Heart You do have a good point Ginnie
I just tend to soft pedal the war drum thing, given my line of work.... BUT, I will add I was glad when my doc sent me for the third surgery on my right arm because of his sincere deep fear my nerve would completely die and with it my use and retention of the appendage. SO, being already involved with a Worker's Compensation attorney on my matter, I proceeded to obtain care while he worked out the fine points of the insuror better get it right or things could be many factors worse......

It worked for me, but then I was already deeply involved in this Humpty Dumpty reassembly chronology.

Yep,
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Old 12-28-2011, 11:12 PM #28
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I am hoping (praying) that I can get help with whatever insurance doesn't cover because of my low income. But this IS something to consider. onder:
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Old 12-30-2011, 11:05 PM #29
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Default Looks like we are going to wait a bit...
The doctor thinks we should try some more lumbar blocks, terazosin, and biofeedback before trying to get the insurance company to pay up. This particular company is not necessarily aware of my entire RSD past so we are going to give what relief I can get and continue to fight with them. SO it's good and bad news. :-)
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