Re: HMO insurance denied specialist. ALSO

["Jackie G." <3putts@xxxxxxxx>]

Hi David,
My husband, Bob, is currently waiting for his second DBS (the first was done
last January).  The neurosurgeon requires Bob to see the neuropsychologist
prior to the pre-surgical visit.  Aetna Golden Medicare also denied this
back in January, but someone at the neuro's office argued with Aetna and got
it approved.  Now, this same request was submitted and also denied this time
too.  I have not heard anything yet.  We will be seeing the neuro in a
couple of weeks so I will find out.  I am sure you are correct though, the
insurance companies just want the insured to pay more, including the premium
which QUADRUPLED in price as of January 1, 2000.  Also, as of Jan. 1 we now
pay for all of the medicine ourself too!  Big business as usual.  We can't
find any decent insurance for Bob because he is 49 and on Medicare, no one
will cover him.  What good is insurance if it won't cover sick people?
Jackie

> Hi all,
>
> I just found out that my insurance co.  denied me to see a
> neuropsychologist.  GRRRR. This referral was made about 1 1/2 weeks ago.
>
> I think this may also be  the case with seeing a movement disorder
> specialist.  I haven't heard a word, and its been at least a month since
the
> referral.
>
> Anyone out there have any ideas on how to "light a fire" under the
insurance
> company's B-hind?
>
> Is this just a game they play to try to get people to pay on their own?  I
> have had to pony up too many times in the past, even after the referral
was
> accepted (different co).
>
> Thanks,
> David Meigs