1 Topic by Mark S (edited by Mark S Wed, 17 Mar 2010 14:25:57)

  • Registered: Mon, 01 Mar 2010
  • Posts: 23

Topic: Help for Underinsured Patients from PAF

I am forwarding on some great information from the Patient Advocate Foundation (PAF) regarding the launch of a new National Underinsured Resource Directory.

In the spirit of full and open disclosure, I must state that in addition to currently battling my own CCA cancer, I am a volunteer State Policy Liaison as well as a paid consultant for the National Patient Advocate Foundation (NPAF), the sister organization to PAF.
------------------------------------------------------------------------------------------------------------------------
Patient Advocate Foundation has recently launched a ground-breaking new online tool called the National Underinsured Resource Directory  which is intended to help underinsured individuals and families locate important resources and seek alternative coverage options or methods to cover their healthcare needs.

The National Underinsured Resource Directory is available through an online interactive tutorial program, and a written publication that supports the program.  The comprehensive online tool will help underinsured Americans faced with high out-of-pocket costs locate valuable resources and action steps to provide financial relief. The link is: http://www.patientadvocate.org/help4u.php

  • Registered: Thu, 19 Feb 2009
  • Posts: 87

Re: Help for Underinsured Patients from PAF

Thanks for posting the link. I just requested help with medical bills. My Insurance , BCBS, of Oklahoma, just again denied paying for PET scan. Says this is a expiramental or investigational precedure. I had the hospital call me again last night, wanting payment, but, you see, this hospital, everytime you walk in the door, opens a new account. I have at this time 5 different accounts, so even though we are making paments, on the oldest account, they sent the others to collection. I am just getting overwhelmed with all the bills and have at this time, stopped going for my checkups, thus, even though it would be time for another ct scan or pet scan, I just can not handle getting one more medical bill.   I certainly look forward to hearing from your organization, and will report back here if they are of any help ! Just sign me extremely frustrated at this point!!

  • Registered: Fri, 12 May 2006
  • Posts: 8,173

Re: Help for Underinsured Patients from PAF

Jill....does the insurance company deny payment for a CT scan?  I don't know about PET however, we had Blue Cross/Blue Shield and they always paid for a CT.  Does your physician insist on a Pet scan?
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER
  • Registered: Thu, 19 Feb 2009
  • Posts: 87

Re: Help for Underinsured Patients from PAF

Marion, they do pay for the ct, partially. These bills are for what the insurance will not pay and our local hospital does not have an agreement with BCBS, so whatever they don't pay, becomes my responsibility.  I also got notice of non payment of PET, today, at another hospital where they do have the agreement, however, since they deemed it, experimental, the statement says I have to pay these charges, looks like about six thousand dollars.

Both the oncologist and my surgeon, did request the pet scans. Says it is the best tool they have to detect cancer.....

  • Registered: Fri, 12 May 2006
  • Posts: 8,173

Re: Help for Underinsured Patients from PAF

Jull.....you might want to ask the physicians to go to bat for you.  Ours did with great results.  Physicians are able to speak with the insurance company physicians and generally, approval will follow.
Best wishes,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER
  • Lainy
  • Lainy
  • Moderator
  • Offline
  • From: Phoenix AZ
  • Registered: Fri, 13 Jan 2006
  • Posts: 8,218

Re: Help for Underinsured Patients from PAF

Jill I posted this on another of your sites today but our Docs also went to bat for us and got it.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.
  • Registered: Thu, 19 Feb 2009
  • Posts: 87

Re: Help for Underinsured Patients from PAF

Thanks Lainy and Marion.

Here is the thing. This time last year, same thing. I wish to get this resolved for all of us in Oklhoma. I have found where other state insurance commissioners, have taken them to court and ruled that the PET scan is not experimental. Our commissioner has sent me a form to fill out and send in and believe me, I am printing out the other states findings to send along with.  We, paitents and familiy members , should not have to fight this every single time it comes up. GRRRRRRRR

  • Lainy
  • Lainy
  • Moderator
  • Offline
  • From: Phoenix AZ
  • Registered: Fri, 13 Jan 2006
  • Posts: 8,218

Re: Help for Underinsured Patients from PAF

You GO Girl! One of these days the world will start hearing so much of us that the words CC  will be as well known as others. Its like a bitter sweet thing but has to be done.  No one outside our "family" has a clue what a big step each accomplishment we do makes. Good luck.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.
  • From: South Elgin, IL (near Chicago)
  • Registered: Fri, 12 Mar 2010
  • Posts: 303

Re: Help for Underinsured Patients from PAF

Jill,

I just saw your post about insurance here!  Way to go!  Thanks for your work in Oklahoma where it may also impact other states everywhere.  Could we get a little continuity around here with this thing?  (insurance and the treatment of it?)

Linda Z.

"Life is not about waiting for the storms to pass...
it's about learning how to dance in the rain."
  • Registered: Thu, 19 Feb 2009
  • Posts: 87

Re: Help for Underinsured Patients from PAF

Still have not heard a single word, via email nor phone call from this PAF.