New fiscal year/insurance problems

• By MarionW
• Posted July 1, 2009 at 10:53 pm
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That is sooooo not OK. Every state has a Department of Public Health Services- Licensing and Certification. You can file a complaint with them against the facility where this happened. They will come in and look at the policies and procedures to be sure they followed them. If they had, the clearance with the insurance company would have been obtained timely.

You can also contact the insurance company and file a complaint.

This is not a small deal. The poor woman was denied timely and essential treament due to red tape- not to mention the physical and mental stressors she suffered because of this.

The facility usually blames the insurance company and the insurance company blames the facility. That is why the Department of Public Health needs to go in and see what they were supposed to do so that wouldn't happen to you or anyone else. Policies and Procedures should be in place.

My thoughts and heart are with you as this was so not necessary.

Big Hug!

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• By DWSC
• Posted July 2, 2009 at 6:24 am
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Thanks, Marion. I am thinking of contacting the insurance company at the very least to complain. We have never had problems with the facility until now; they have been very professional and caring. However, something needs to be done. My mom wasn't the only one this happened to yesterday.

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• By cuddles53
• Posted July 2, 2009 at 10:49 am
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Also try calling the New York state health department they can lead you on who else to call, I would even call my governor's office, have heard of it working before, this is no joke, and they should not make her wait while they are on coffee breaks! I am so frustrated with our insurance companies holding the bag all the time, we sit idly by, they waste more money sending out paperwork everyday, wasting stamps to inform of us privacy, and so many other really stupid ways to spend money our money. We all know our privacy is just a bunch of BS, all people in the medical community have access to our records on computers. If they have a code to get in which many do, then how private is that? Take one look at the internet, just because we inquire into something relative to our medical condition, we get nailed with medicine information, HOW PRIVATE ARE WE REALLY.The insurance companies need to be accountable to their customers, yes, customers, not continually trying to disqualify us due to our medical conditions., we paid for this insurance, in good faith, now pay out on our claims......I am a very angry patient!!! I can not believe what I have seen since I have been ill with cancer. doctors keeping us on drugs that don't work, oncologists who do not refer patients for sensitivity testing when they know it works! What kind of medical teams have we got going here, and why can we not get access to other countries approved cancer medications, I thought it is United we stand as a world not as a hospital cancer center>? Thanks for hearing me vent!!
God bless all who have to go through this mess.
Sandy

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• By debra1
• Posted July 2, 2009 at 12:23 pm
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I hate Ins. Companies and I will not get started because it is hard for me to stop. They are one of the wealthiest Companies in the US and they will pay chemo drug today but not tomorrow????.....I would contact them and make sure it was not the facility, then I would contact my State Board of Ins. who governs them. Again, I hate Ins. Cos, they rule our lives and you just can't risk not having ins. Of course on our car and home ins., if we use it for a claim, ins. usually goes up or they cancel you. ok, enough from me......

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• By AliceL
• Posted July 2, 2009 at 12:38 pm
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I have had these "insurance preapproval issues" also, but fortunately I wasn't kept waiting in the infusion room for 6 hours! I'm not sure what this preapproval stuff is all about, especially when you've had it before. Obviously it must all come down to money somehow. There was only one nausea med that worked for me, and I had to have preapproval each time and was only allowed 12 pills, so I didn't want to take them as I'd run out and would have to wait several weeks to get more -- same with the Aranesp which they give for low red blood cell counts -- needed preapproval.

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