[Diabetes-talk] Help with insurrance coverage of Prodigy Voice

[Sandra Murillo]

Hi Cheryl,
 
Thanks for your quick reply. Indeed, I know you from the diabetes list (I've been a member for only 5 months.) My insurance provider is HMO Blue Cross Blue Shield of Illinois. To my knowledge, my doctor never sent a letter to the insurance stating that I am blind. Again, I am not sure of this, so I will call HomeCare and my insurance tomorrow to find out the exact reason for the denial. I will be sure to get back with you ASAP.
 
Thanks for your help, and happy holidays!
Sandra



--- On Thu, 12/25/08, cheryl echevarria <cherylandmaxx at hotmail.com> wrote:

From: cheryl echevarria <cherylandmaxx at hotmail.com>
Subject: Re: Help with insurrance coverage of Prodigy Voice
To: sandramurillo_580 at yahoo.com
Cc: "diabetes-talk" <diabetes-talk at nfbnet.org>
Date: Thursday, December 25, 2008, 7:01 AM






Sandra:
 
I am also posting this on the diabetic talk site so that way people know in the future what to look out for being blind and diabetic supplies.
 
merry christmas sandra and happy new year.
 
Can you let me know where you know of me I am guess the diabetic talk list.
 
I need to know a few things first, what insurance company denied the claim.  It could be for one of a few reasons why they denied it.  
 
1.  Your insurance company may not have a contract with Homecare supply company you could have gone out of your network and you may not have out of network benefits.
If this is the case then HomeCare is at fault.  They should have never processed the order without verifying with your insurance.
 
2.  Please let me did you try and contact your insurance company, a lot of insurance companies especially with diabetic supplies unless you have a doctor letters stating you are blind accompanying with your order the insurance companies will not pay.
 
3. Insurance companies are trained to deny at least 5-10% of all claims for no apparent reason, that is why the government needs to get there noses in these business so that they can control what they are doing.
 
But the funny part is they are also losing money.  As I see in when I get denials at my job for customers.  at least 20% more patients in december lost there insurance and have canceled insurance.  Without customers they will feel the punch themselves sooner or later.
 
If you get back to me  with some more information as to why they denied the claim, I cannot do more please do your homework.  And this isn't over yet you can appeal it.   So do your homework. call on Friday or monday morning to your insurance company and to Homecare they need to tell you why it was denied first and then we can go from there.
 
Take care.
 
 
 
Cheryl Echevarria
Treasurer
National Federation of the Blind Greater Long Island Chapter
Member NAGDU, NYAGDU and DAN

----- Original Message ----- 
From: Sandra Murillo 
To: cheryl echevarria 
Sent: Thursday, December 25, 2008 12:01 AM
Subject: Help with insurrance coverage of Prodigy Voice






Hello Cheryl
 
Sorry for the unfinished message I sent you a few minutes ago. I am wondering if you might be able to assist me with a snag I ran into regarding the coverage of the Prodigy Voice Meter and it's supplies. I ordered the meter and supplies from HomeCare Supply of America in July. The company took care of everything -- including the insurance paper work. When I called them to check if my HMO covered the equipment, they told me that everything would be covered. I got the meter and supplies for 3 months. When I ran out of strips and lancets, I called HomeCare Supply of America to order more. During this call I found out that my insurance had not paied my initial order, and therefore, they could not send me more supplies. For the past month I have called HomeCare several times, but each time they are never able to tell me what is going on with the insurance payment.
 
Today I received a letter from my insurance telling me that they had reviewed my case, and they would not pay this equipment. What can I do, because I seriously don't understand their decision -- I am totally blind, and as we know, the Prodigy Voice is one of the few meters I can use independently. I would have used Medicaid to cover this equipment, but HomeCare told me they currently don't except it as a form of coverage. Please help me. Do I need to appeal the decision, or what can I do?
 
Thanks,
 
Sandra Murillo