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

[cheryl echevarria]

no not to the insurance company, when you order items such as the prodigy 
voice etc to a company like your Homecare, you need to send proof of 
blindness to them, not to the insurance company, you doctor will not send it 
to the insurance company, what you should do to apply it, is make sure your 
doctor contacts your insurance company and let them know it is a medical 
necessity, second did you ever send to homecare or did they ask you to send 
proof of blindness.

Cheryl Echevarria
Treasurer
National Federation of the Blind Greater Long Island Chapter
Member NAGDU, NYAGDU and DAN


----- Original Message ----- 
From: "Sandra Murillo" <sandramurillo_580 at yahoo.com>
To: "cheryl echevarria" <cherylandmaxx at hotmail.com>
Cc: "diabetes-talk" <diabetes-talk at nfbnet.org>
Sent: Thursday, December 25, 2008 1:24 PM
Subject: Re: Help with insurrance coverage of Prodigy Voice


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