PDA

View Full Version : Insurance help...PLEASE!



three.little.boys
04-14-2008, 01:39 AM
Ok- I need some help fighting our insurance company. Has anyone had first hand experience with working at an ins. co, or fighting one? I recieved a letter from the neurosurgeon's office the other day saying that they are sending one more appeal, but it was not looking good, so they ask that I send an appeal as well. Here is what I cam up with...anyone that has the TIME...could you read it and give me your opinion??? THANKS!!! HONEST OPINIONS, please! I have not sent this yet...just spent 3 hrs on it, though!


April 13<SUP>th</SUP>, 2008
Blue Cross Blue Shield
Attn: Medical Director/ Appeals
PO Box 660044
Dallas, TX 75266-0044


Dear Sir/Madam:

My son, Quintin, was diagnosed on December 11, 2007 with Craniosynostosis of the Metopic suture resulting in Trigonocephaly. We then found out that Quintin would need a surgery called a CVR/FOA (Cranio Vault Reconstruction/Frontal Orbital Advancement) to correct this birth defect. If we did not have the surgery done then Quintin had over 15% chance that he would suffer brain damage. He was already having balancing issues as a result. This is a chance that NO parent would gamble on for their child!

I am writing this letter to appeal to you to please consider what you deem “reasonable and customary” for some of the charges incurred during my son’s corrective surgery. We are a family of 5 living on a single income. You will find in the paragraphs below our story of how we tried our best to first find a surgeon IN NETWORK for BCBS KC, but came up empty handed. Please review the following information and reconsider the amount BCBS is willing to pay.

Quintin’s diagnosis came from Dr. John Hiebert, MD, from the Hiebert Center at St. Luke’s Hospital in Kansas City on December 11<SUP>th</SUP>, 2007 . This diagnosis was made via a 3D CT scan performed the same day. Dr. Hiebert was in-network for our insurance policy with BCBS KC. We set a surgery date for mid-January.

After this stunning diagnosis my husband and I decided that I should research this condition more and make sure our son was receiving the best treatment. After further research, I realized that Dr. Hiebert was not a good candidate for our sons invasive surgery. Therefore, we were FORCED to look for other surgeons for our child’s safety! Here are the reasons why we decided Dr. Hiebert was not a good choice, and actually downright risky!:

Dr. Hiebert only performs ONE CVR surgery a month. The rest of his practice is other plastic surgery…mainly breast augmentations and face lifts.
Dr. Hiebert is the Medical Director for Fig, a Kansas City based plastic surgery clinic that performs the highly controversial LipoDissolve. This procedure has been banned in Kansas, but not yet Missouri. There are several class action lawsuits against Fig regarding this risky treatment…yet Dr. Hiebert endorses it?
Dr. Hiebert wanted to do an older type of surgery than the CVR. I believe the surgery he wanted to perform was called a Barrel Stave Osceotomy (sp??), which is known to cause more bleeding in the child and is not as effective in treating this condition as the more standard CVR surgery.
Dr. Hiebert wanted to install a peripherally inserted central catheter- (PICC or PIC line) into Quintin for 3 weeks to deliver a medicine called Procrit to him to boost his hematocrit levels. While the research I did does support the use of Procrit, everything I read said that Procrit could be given with a simple shot…not a PIC line that can expose the child to infection! (the surgeon I decided to use, Dr. Fearon, was able to collaborate with my local pediatrician to give Quintin his Procrit through a simple shot at her office once a week for 3 weeks) I would have to “FLUSH” this PIC line twice a day inflicting pain on my child and possibly introducing bacteria!
Dr. Hiebert also wanted my son to wear a molding helmet for 6 months after surgery. All research shows that this is NOT usual for a complete correction surgery for metopic craniosynostosis. Instead, the molding helmet is optimal for positional plagiochephaly or endoscopic craniosynostosis surgery, which Quintin was too old to be a candidate for. The helmet could actually cause Quintin’s skull more harm then good after surgery!After our decision NOT to use Dr. Hiebert was made, we realized we needed to find another craniofacial surgeon. We then looked into Dr. Singhal at Children’s Mercy Hospital in Kansas City. This surgeon is also in network for BCBS KC. Unfortunately, Dr. Singhal was booked solid and his first available consultation was not until May 2008...which was 5 months away from Quintin’s diagnosis. Quintin was already 8 months old at diagnosis, and the optimal age for craniosynostosis corrective surgery (CVR/FOA) is between 8-12 months old. Quintin would have been 15 months old before Dr. Singhal would have even had a consultation with him! So, Dr. Singhal was not a viable option for Quintin’s surgery, either.

We then learned that there was only one other surgeon who performs this type of surgery in Kansas City…and he was trained by Dr. Hiebert, who was the first surgeon we saw! His practices were similar to Dr. Hiebert’s, and we had already deemed them unsafe.

So, as parents, where do we turn now? We turned to the world renowned pediatric craniofacial specialist, Dr. Jeffery Fearon of Pediatric Plastic Surgery, PLLC in Dallas, TX. Dr. Fearon performs over 80 CVR surgeries on pediatric patients annually. He has a lower blood transfusion rate of about 50%…compared to the national average of almost 100% for this type of surgery! Also, his patients spend on average 50% less time in the hospital. His patients average 2-3 nights ion the hospital after surgery vs. 5-6 nights as a national average. Dr. Fearon was and is still an angel in disguise for our family and son!

Dr. Fearon agreed to take on Quintin’s case, and surgery was set for February 19, 2008 when Quintin would be 10 months old. Dr. Fearon ONLY uses a select few handpicked surgeons and doctors to be on his surgical team. These doctors comprise of pediatric neurosurgeons and pediatric anesthesiologists that have had extensive experience with Dr. Fearon in doing this very surgery….thus minimizing the risk to the child. Therefore, we did not have the option to pick a neurosurgeon or anesthesiologist that was in-network for BCBS KC. But, we had already exhausted all of our in-network options in Kansas City…so we had no choice!

The surgery was performed as planned on Feb. 19<SUP>th</SUP> and went wonderfully! Quintin DID NOT need a blood transfusion and only needed to stay in the hospital for 2 nights. He has thrived ever since and I am 100% positive that we made the best decision when choosing our surgical team of Dr. Fearon and his colleges.

Then the bills came. I thought we would be paying our out-of-network maximum coinsurance of $3,750 plus a little extra, perhaps. Boy, was I wrong!

Our bill for Dr. Sacco, pediatric neurosurgeon, came in at $9,204.00, and BCBS agreed to cover only $4,532.92. This leaves us to pay the remaining $4,532.92 PLUS an additional 40% coinsurance of the amount BCBS has agreed to pay! This is absurd! I have been advised that this level of coverage is WAY below the standard of what is considered “reasonable and customary” for the Dallas area! I believe this is acting in bad faith, and I would hate to have to contact the Texas Department of Insurance!

Also, the charges for Dr. Fearon, craniofacial surgeon from Pediatric Plastic Surgery, totaled $13,080, and BCBS agreed to cover ONLY $2090.35 with a plan payment of only $926.95!! This is absurd that I am left with the balance of $12,153.05 when we hold a very good insurance policy that my family and my husband’s work pays approximately $1,000 a month for coverage! Our insurance policy is a contract, and we agree to pay our premium each month, and it is BCBS responsibility to hold up it’s end of the bargain and cover our son’s corrective surgery at an appropriate rate!!

The charges for the anesthesia was $2,560, and once again, BCBS has left almost HALF of this bill for me and my family to cover! BCBS agreed to cover $1,390.38 leaving us $1,169.62 to pay! This, also, is not acceptable and is also acting on bad faith on BCBS’s part!

Finally , a charge to Pediatric Acute Care Association for service on 2/19/2008 was filed for $496.00, and BCBS agreed to cover $114.20 Once again, this leaves us with a balance of $381.80! A second charge for the date of 2/20/2008 was $397 and BCBS covered only $95.50. WHY?? These were services rendered at an IN NETWORK hospital, Medical City Dallas, and were doctors working for this in-network hospital. We were not even aware of these doctors, nor were we given the choice to find an in-network doctor!

In closing, we did the responsible thing for our child by finding him a surgical team that was capable of safely performing this surgery and performing it in a timely fashion before his skull hardened too much to repair correctly. But, we are being punished by BCBS for seeking out quality medical care. Please take our situation to heart and see that we are a normal family just trying to survive in this financially unstable time. We were unaware that we would be left with SO MUCH of each bill as our responsibility and burden! Like I said before, I would hate to have to bring this matter up to the Texas Department of Insurance. But, I will if I have to. There is one thing I have a lot of…time! We may not have much money, but I do have the time to address this situation properly and fight for my rights as a policy holder!

Thank you for your time and consideration.
Regards,

Sadie Decker

Member ID
Group Number
Policy holder name: Anthony R. Decker (my husband)
Policy offered by Burns and McDonnell Engineering

Elizabeth
04-14-2008, 07:55 AM
Sounds good to me! I can't BELIEVE how much they are expecting you to pay! That is insane. I totally agree that you shouldn't have to pay more than your out of network out of pocket maximum. YOU FIGHT, momma!!

Q looks awesome, by the way.

Tamz
04-14-2008, 08:14 AM
Sadie I think you said everything right you and your Family should not have incurred those kind of charges.

mattricia
04-14-2008, 08:21 AM
GREAT letter, Sadie. Wow, it's unreal what they're putting back on you!!! I think you've represented yourself very well. The only thing i might change is the "i'd hate to contact the TX Dept of Ins". Tell them you'll relish doing it! Ha. Maybe not relish...

Good luck and keep us posted!

three.little.boys
04-14-2008, 10:12 AM
Thanks guys...it makes me feel good that you guys have read it and think it sounds good. I used some tips from the "fighting the insurance co" topic on cappskids. Thanks you for taking the time to read it...it is loooong!!! But, they said I might have a chance if I explained my situation and that I tried to go in network.

Candice
04-14-2008, 10:22 AM
Great job Sadie-Girl!!! I am so sorry you have to deal with this,I can't even imagine. When K was born I had her put under DH's insurance not mine. Mine was BCBS....it looks like I'm glad I did! BCBS is supposed to be really good, but lately I'm hearing so much crap. Hell, maybe all insurance companies are evil...

EmmaLacey
04-14-2008, 10:24 AM
Sadie, you did a great job. Hopefully they will reconsider. I can't imagine having to pay for all those bills. Good luck and let us know!

Jenny
04-14-2008, 10:46 AM
Sadie, I actually used to process claims for bcbs a few years ago. I certainly hope your letter works! I didn't deal too much with the appeals department, but I know with bcbs they like to stick to their guns. If there was a doctor that was in network that could have done the care, they will stick to it. as far as the customary charges, i have never heard of them adjusting the amounts. But all i can say is keep fighting! I used to have a father call me every week for claims for his daughter, who was extremely ill, and we just kept fighting for him. I ended up leaving before his case was finished, but I know he did get some of his claims resolved. Hopefully you'll get someone to review it that has a little sympathy, good luck!

three.little.boys
04-14-2008, 11:22 AM
Thanks Candice, Nancy and Jenny!!!

xl1200c
04-14-2008, 01:40 PM
Sadie,

With our insurance, what helped get everything through was a letter from our pediatrician stating that it was medically necessary for us to be out of network. Once we had that letter, all else went well. Just wanted to mention it.

craniomommynbaby
04-14-2008, 01:42 PM
I would change the "I hate to contact..." part to something about that being my next step if BCBS does not act quickly to resolve the issue.
Good luck! We ran into the same issues with Simon's surgery and BCBS. Fortunately, we were able to deal with it beforehand and get Medicaid to cover the balance. Our state laws did not help in my case as BCBS was not listed as the ones creating the policy. It was a weird loophole that left me with no legal recourse. Otherwise, I would have gotten a lawyer's help.

three.little.boys
04-14-2008, 02:22 PM
Thanks guys....
Cindy- I think that is a good idea to make that change

Cathy- good idea...I will try that, too!

Candice
04-14-2008, 02:49 PM
Yes definately the letter from the ped!!! Our pedi wrote a letter to our insurance stating we had to go to Denver for Kendall to be treated, I think it helped a bunch!!!!!!

Springy
04-14-2008, 03:31 PM
Sadie, The pedi idea is great!! Also, I am assuming that Doc fearon is out of network? Or was it a code issue? Sorry I am lost.

three.little.boys
04-14-2008, 03:38 PM
yes- he is out of network. Actually- he is out of network for pretty much everyone. But, the $10,000 approx that the ins. will not cover may be partially written off by Dr. Fearon after all is said and done by the ins. He does this a lot with familied to help them out. He is SO NICE! The NS is a different story!

Keep in mind that we have almost $2,00 in travel expenses for the two trips down there! (hotel, food, rental car, plane tickets, parking, the list goes on!!) Sorry- I had to whine a bit!!

three.little.boys
04-14-2008, 03:39 PM
BUT- It was worth every penny for Q to get to see Dr. Fearon...especailly after our options here in KC!!!

Springy
04-14-2008, 03:43 PM
I dont blame you! I love our PS BUT BUT BUT Libby has two new ridges and no explanation except that it may be from what she has going on metabolically! I hate that!

I wish I could help! My help to you would be to let you bitch and whine to me!! HEHEHE

Amy K
04-15-2008, 10:40 PM
Sadie, I'm so angry and irritated for yall having to go through this! STupid insurance!!! Have you asked Dr. Sacco to write a letter and go to bat for for you?

three.little.boys
04-15-2008, 10:47 PM
Amy- nope, not yet. Was Dr. Fearon in network for you. I don't think he is in-network for anyone. What did your ins. co. cover for Camden (if you don;t mind me asking...PM me PLEASE!!)...also, were the NS in-network for you guys???

Amy K
04-15-2008, 11:08 PM
I don't think any of it was in network for us! My husband dealt with all of this stuff...and all we've gotten is the bill from Medical City. Now I'm thinking oh gosh what if we get more bills from the surgeons!! We have an HMO and they cover almost everything IF they've authorized it, of course...now I feel an overwhelming need to make some calls and make sure it was all authorized!! I know Fearon was ok'ed...but now I'm thinking of Swift (ns)....crud. So far all we have to pay is our hospital co-pay.

I seriously think you should have Sacco write a letter...that's what Fearon did for us in the beginning, and then finally insurance came through for us.

Amy K
04-15-2008, 11:19 PM
Sadie, I'm going to pm you....

beccad
04-16-2008, 12:58 PM
Sadie, I'm just now getting on reading this. I'm sorry about all of this, but you did what was best for your son and that is all that matters. I hate how they have a "I don't care attitude". I hope it all works out for you.

SamanthaLei
04-16-2008, 01:14 PM
Sadie I am so sorry I am just now reading this! I'm soooo worried about what our medical bills are going to add up to now!
I think your letter was great - have you sent it?
I wish Dr. Sacco's office was a little bit better as far as helping you with the fight...
I called BCBS and asked them to include Dr. Sacco as in-network because he's the only pediatric NS in Dallas and they approved that.. but said it has nothing to do with their "reasonable and customary amounts".
When that got approved I also called and begged them to count Dr. Fearon as in network. They also approved that saying it had nothing to do with how much they would deem "reasonable and customary".
So we'll see... I'm so sorry you guys are going to have to battle this one. Keep us updated on how it goes.

three.little.boys
04-16-2008, 04:43 PM
Thanks...just sent the letter. We got my hubbys HR deopartment involved.

CMMartos
04-22-2008, 11:55 AM
It does sound like BCBS is acting in bad faith. You really should only be out the40% out of network co-insurance or the out-of-network cap...and that is IF they refused to do a single-event in-network contract (they can agree to contract with a doctor for one surgery if there are good reasons).

Keep fightng them, I've learned that BCBS double-bills and does this crap on purposed. Keep fighting them!

marisajo
04-23-2008, 02:18 PM
Sadie, Any news yet on whether your insurance will cover? This info was so important for me to read, as we are about to follow in your footsteps. Our out-of-network out-of-pocket max for him is $2250, so I would have assumed that was what we had to pay and that anything above "reasonable and customary" would still be written off for an out-of-network dr, so I'm glad you spelled it out that it wasn't. I called my insurance company today, and they sent his case to the waiver dept. I think we've got a decent case...the ONLY in-network pediatric plastic surgeon is the one who's already had 2 chances and wants to do a third surgery just like the failed second one. Medical City Dallas is also in-network for us, so if I'm successful in getting Dr. Fearon covered at in-network rates, then I'll move on to anesthesia (and ns if he ends up needing the CVR instead of cranioplasty.)

Hope you are successful! You post definitely made me want to try to work it all out up front!

three.little.boys
04-24-2008, 01:38 AM
no news yet. This will be a long drawn out process!

Heads-up....Medical City Dallas was in-network, but the doctors in the PICU were not, even though they get PAID by Medical City Dallas!! We have an over $1,000 bill from them, too!

marisajo
04-24-2008, 07:57 AM
Sadie, thanks for that little tidbit. That's definitely different than here where we always have an inpatient hospital copay, plus 10% of ns, ps, anesthesiologist, and hospital supplies up to out-of-pocket max, which is only 1350 for in-network.

I hate that the drs won't write off the amount above the out-of-network rate. It's seems logical to me that you'd have to pay the difference between what insurance deems "reasonable and customary" and what they would get if insurance considered them in-network, but not to pay the difference up to the whole thing that was billed. What gets billed always seems like such an inflated number to me, as our in-network insurance usually covers only about half. I wonder if they ever agree to write any amount off for out-of-network folks.

Like you, I won't let it stop me. Since I won't let our current ps touch him again and I have NO other in-network choices, I'm going to have to fight the fight regardless to get him care somewhere. Dallas' charges don't seem out of line (maybe even significantly less - I can't remember) than what I was charged here, so hoping that may work to my advantage. I'm glad there's no huge hurry so I have time to try to work it all out, though now that we have the surgeon, I would LOVE to get it all behind us!

SamanthaLei
04-25-2008, 09:58 AM
Sadie I just got online to look at BCBS claims.. they're worse than yours! I'm going to PM you. Now I'm in this same awful boat!