Double copays and denying coverage

L

ldenkers

Guest
We get bills on a daily basis and have only been to 3 appointments to boston childrens CF clinic. We just moved and I am praying it is different at John Hopkins.

Anybody else having problems? They want double co-pays because the doctor bills separate from the hospital (which also happens at John Hopkins so I really hope we don't have to pay twice. Also at Boston they said they called our insurance for pre-authorization and drew blood for Ambry- We have been fighting/disputing/filing grievances since OCT 2009 and still are expected to pay the $7,000.00. Not to mention we have been fighting Boston to cover their heart appointments (chest x-rays found concernes) We did get pre approval from insurance and have medicaid to cover the rest and they are now saying the medicaid lapsed.... and this is just a problem with one baby- the other went through after only 3 or so phone calls. Also going on Since Oct 2009.

We have twins so it's already x2, we can't afford x4!!

So exhausted doing treatments and billing and twins that are becoming mobile. I just can't handle it all. Does anyone else have endless billing problems? Or advice!!?? I don't want the billing nightmares to keep happening here at John Hopkins. I just am about to shut down entirely. Don't they get anyone going to these CF clinics have enough problems??? (thanks for letting me vent and I apologize this is rambling on)...
 
L

ldenkers

Guest
We get bills on a daily basis and have only been to 3 appointments to boston childrens CF clinic. We just moved and I am praying it is different at John Hopkins.

Anybody else having problems? They want double co-pays because the doctor bills separate from the hospital (which also happens at John Hopkins so I really hope we don't have to pay twice. Also at Boston they said they called our insurance for pre-authorization and drew blood for Ambry- We have been fighting/disputing/filing grievances since OCT 2009 and still are expected to pay the $7,000.00. Not to mention we have been fighting Boston to cover their heart appointments (chest x-rays found concernes) We did get pre approval from insurance and have medicaid to cover the rest and they are now saying the medicaid lapsed.... and this is just a problem with one baby- the other went through after only 3 or so phone calls. Also going on Since Oct 2009.

We have twins so it's already x2, we can't afford x4!!

So exhausted doing treatments and billing and twins that are becoming mobile. I just can't handle it all. Does anyone else have endless billing problems? Or advice!!?? I don't want the billing nightmares to keep happening here at John Hopkins. I just am about to shut down entirely. Don't they get anyone going to these CF clinics have enough problems??? (thanks for letting me vent and I apologize this is rambling on)...
 
L

ldenkers

Guest
We get bills on a daily basis and have only been to 3 appointments to boston childrens CF clinic. We just moved and I am praying it is different at John Hopkins.
<br />
<br />Anybody else having problems? They want double co-pays because the doctor bills separate from the hospital (which also happens at John Hopkins so I really hope we don't have to pay twice. Also at Boston they said they called our insurance for pre-authorization and drew blood for Ambry- We have been fighting/disputing/filing grievances since OCT 2009 and still are expected to pay the $7,000.00. Not to mention we have been fighting Boston to cover their heart appointments (chest x-rays found concernes) We did get pre approval from insurance and have medicaid to cover the rest and they are now saying the medicaid lapsed.... and this is just a problem with one baby- the other went through after only 3 or so phone calls. Also going on Since Oct 2009.
<br />
<br />We have twins so it's already x2, we can't afford x4!!
<br />
<br />So exhausted doing treatments and billing and twins that are becoming mobile. I just can't handle it all. Does anyone else have endless billing problems? Or advice!!?? I don't want the billing nightmares to keep happening here at John Hopkins. I just am about to shut down entirely. Don't they get anyone going to these CF clinics have enough problems??? (thanks for letting me vent and I apologize this is rambling on)...
<br />
<br />
<br />
 
M

Mommafirst

Guest
I think the first thing you need to do is pull out your original insurance documents to find out your rights and responsibilities as far as billing etc. I can imagine this is just overwhelming and emotionally exhausting.

If you haven't already, contact your CF social worker to help figure this out. You might also consider calling the CF Legal Hotline to see if you qualify for help in figuring this all out. They are usually very helpful, I'm just not sure if this is a legal issue or just a plain old insurance one. The 1-800 number is on the CFF.org website.

((((HUGS)))) hang in there. CF sucks. I have never had these crazy issues, but there should be answers for you.
 
M

Mommafirst

Guest
I think the first thing you need to do is pull out your original insurance documents to find out your rights and responsibilities as far as billing etc. I can imagine this is just overwhelming and emotionally exhausting.

If you haven't already, contact your CF social worker to help figure this out. You might also consider calling the CF Legal Hotline to see if you qualify for help in figuring this all out. They are usually very helpful, I'm just not sure if this is a legal issue or just a plain old insurance one. The 1-800 number is on the CFF.org website.

((((HUGS)))) hang in there. CF sucks. I have never had these crazy issues, but there should be answers for you.
 
M

Mommafirst

Guest
I think the first thing you need to do is pull out your original insurance documents to find out your rights and responsibilities as far as billing etc. I can imagine this is just overwhelming and emotionally exhausting.
<br />
<br />If you haven't already, contact your CF social worker to help figure this out. You might also consider calling the CF Legal Hotline to see if you qualify for help in figuring this all out. They are usually very helpful, I'm just not sure if this is a legal issue or just a plain old insurance one. The 1-800 number is on the CFF.org website.
<br />
<br />((((HUGS)))) hang in there. CF sucks. I have never had these crazy issues, but there should be answers for you.
 
C

Cherylwithone

Guest
I don't think they can double copay you on appointments.
If you have an appointment then it should be one copay.

The only thing I think they might be able to double copay you is bringing in both twins to be seen because the insurance co. is billed for each child and not as a unit.

I agree with Heather. Get one of the social workers involved. Insurance co. can be very trickey to deal with.
That fine print can get you.

You would think that having twins is enough stress without them tossing the extra bills out there.

Also, even if you sent them just $25.00 amonth I don't see how they can say anything. Your attempting to pay them.

Hugs to you.

Also, in this game of insurance you will learn to write letters and have them signed receipt and keep copies of everything. See if your insurance has a web site that you
can check for the pre approvals and referrals in advance.
My insurance has it. It makes life a little bit easier.
 
C

Cherylwithone

Guest
I don't think they can double copay you on appointments.
If you have an appointment then it should be one copay.

The only thing I think they might be able to double copay you is bringing in both twins to be seen because the insurance co. is billed for each child and not as a unit.

I agree with Heather. Get one of the social workers involved. Insurance co. can be very trickey to deal with.
That fine print can get you.

You would think that having twins is enough stress without them tossing the extra bills out there.

Also, even if you sent them just $25.00 amonth I don't see how they can say anything. Your attempting to pay them.

Hugs to you.

Also, in this game of insurance you will learn to write letters and have them signed receipt and keep copies of everything. See if your insurance has a web site that you
can check for the pre approvals and referrals in advance.
My insurance has it. It makes life a little bit easier.
 
C

Cherylwithone

Guest
I don't think they can double copay you on appointments.
<br />If you have an appointment then it should be one copay.
<br />
<br />The only thing I think they might be able to double copay you is bringing in both twins to be seen because the insurance co. is billed for each child and not as a unit.
<br />
<br />I agree with Heather. Get one of the social workers involved. Insurance co. can be very trickey to deal with.
<br />That fine print can get you.
<br />
<br />You would think that having twins is enough stress without them tossing the extra bills out there.
<br />
<br />Also, even if you sent them just $25.00 amonth I don't see how they can say anything. Your attempting to pay them.
<br />
<br />Hugs to you.
<br />
<br />Also, in this game of insurance you will learn to write letters and have them signed receipt and keep copies of everything. See if your insurance has a web site that you
<br />can check for the pre approvals and referrals in advance.
<br />My insurance has it. It makes life a little bit easier.
<br />
 
C

crickit715

New member
contact cindy the social worker at johns hopkins (we go there too) and explain what is going on to see if she can help! she is super sweet and helpful with everything!! good luck! ricki
 
C

crickit715

New member
contact cindy the social worker at johns hopkins (we go there too) and explain what is going on to see if she can help! she is super sweet and helpful with everything!! good luck! ricki
 
C

crickit715

New member
contact cindy the social worker at johns hopkins (we go there too) and explain what is going on to see if she can help! she is super sweet and helpful with everything!! good luck! ricki
 
J

julie

New member
My non profit works on these kinds of insurance denials, in addition to the disability stuff- www.dafcf.org

Email me, services@dafcf.org and I can send you some confidentiality agreements for your protection. Feel free to ask around about me/the organization on this forum for validity.
 
J

julie

New member
My non profit works on these kinds of insurance denials, in addition to the disability stuff- www.dafcf.org

Email me, services@dafcf.org and I can send you some confidentiality agreements for your protection. Feel free to ask around about me/the organization on this forum for validity.
 
J

julie

New member
My non profit works on these kinds of insurance denials, in addition to the disability stuff- www.dafcf.org
<br />
<br />Email me, services@dafcf.org and I can send you some confidentiality agreements for your protection. Feel free to ask around about me/the organization on this forum for validity.
 
L

ldenkers

Guest
I've re-faxed all the statements and receipts of payments. I will take up on the social worker if this is still an issue for the double billing each baby and the non profit sounds wonderful if this second appeal/grievance doesn't work on the large bill and the heart appointment. I really appreciate all the help, I am just out of energy for things like this.
 
L

ldenkers

Guest
I've re-faxed all the statements and receipts of payments. I will take up on the social worker if this is still an issue for the double billing each baby and the non profit sounds wonderful if this second appeal/grievance doesn't work on the large bill and the heart appointment. I really appreciate all the help, I am just out of energy for things like this.
 
L

ldenkers

Guest
I've re-faxed all the statements and receipts of payments. I will take up on the social worker if this is still an issue for the double billing each baby and the non profit sounds wonderful if this second appeal/grievance doesn't work on the large bill and the heart appointment. I really appreciate all the help, I am just out of energy for things like this.
 
N

NancyLKF

New member
We haven't had any problems once the CF diagnosis came. Makes me scared to ever leave Vermont since the state program here pays for every single thing CF related regardless of income (so far anyway). But when Maggie was born she was in the NICU for a few days (not CF related) and the bills were over $10,000. I called the hospital to ask if they offered financial assistance. They sent me an application and I filled out a ton of paperwork but it was worth it. They wiped the entire bill clean. We owed nothing. Most hospitals should have this. I don't know if it would apply in your case, but it might be worth checking into.
 
N

NancyLKF

New member
We haven't had any problems once the CF diagnosis came. Makes me scared to ever leave Vermont since the state program here pays for every single thing CF related regardless of income (so far anyway). But when Maggie was born she was in the NICU for a few days (not CF related) and the bills were over $10,000. I called the hospital to ask if they offered financial assistance. They sent me an application and I filled out a ton of paperwork but it was worth it. They wiped the entire bill clean. We owed nothing. Most hospitals should have this. I don't know if it would apply in your case, but it might be worth checking into.
 
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