Our insurance is through the state University system - with many plans to choose from. Last year's (more expensive) plan denied the Hill-Rom vest three times - the last appeal was to the Commissioner of Higher Education, no less. Everybody (me, doctor, Hill-Rom) wrote letters to appeal the denials. We sent the Hill-Rom back. This year, because my lung function was down, my doctor wanted to try again. We got SmartVest (Electromed) and InCourage (Respirtech) for trial periods - kept the InCourage and started the process of filing a claim with the new insurance provider. I was preparing for claim rejection and appeals (writing letters in my head, etc). Heard about a month ago that this year's company sent the claim NOT to outside reviewers (retired pulmonologists, in my opinion) but to the medical director of the insurance company, and it was approved. Nice surprise. Thankfully, we had the option of choosing another insurance carrier - which we actually did because it had lower premiums and still covered my out of state CF clinic care. Win Win???
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Insurance Denial
- Thread starter lightNlife
- Start date
Our insurance is through the state University system - with many plans to choose from. Last year's (more expensive) plan denied the Hill-Rom vest three times - the last appeal was to the Commissioner of Higher Education, no less. Everybody (me, doctor, Hill-Rom) wrote letters to appeal the denials. We sent the Hill-Rom back. This year, because my lung function was down, my doctor wanted to try again. We got SmartVest (Electromed) and InCourage (Respirtech) for trial periods - kept the InCourage and started the process of filing a claim with the new insurance provider. I was preparing for claim rejection and appeals (writing letters in my head, etc). Heard about a month ago that this year's company sent the claim NOT to outside reviewers (retired pulmonologists, in my opinion) but to the medical director of the insurance company, and it was approved. Nice surprise. Thankfully, we had the option of choosing another insurance carrier - which we actually did because it had lower premiums and still covered my out of state CF clinic care. Win Win???
Our insurance is through the state University system - with many plans to choose from. Last year's (more expensive) plan denied the Hill-Rom vest three times - the last appeal was to the Commissioner of Higher Education, no less. Everybody (me, doctor, Hill-Rom) wrote letters to appeal the denials. We sent the Hill-Rom back. This year, because my lung function was down, my doctor wanted to try again. We got SmartVest (Electromed) and InCourage (Respirtech) for trial periods - kept the InCourage and started the process of filing a claim with the new insurance provider. I was preparing for claim rejection and appeals (writing letters in my head, etc). Heard about a month ago that this year's company sent the claim NOT to outside reviewers (retired pulmonologists, in my opinion) but to the medical director of the insurance company, and it was approved. Nice surprise. Thankfully, we had the option of choosing another insurance carrier - which we actually did because it had lower premiums and still covered my out of state CF clinic care. Win Win???
Our insurance is through the state University system - with many plans to choose from. Last year's (more expensive) plan denied the Hill-Rom vest three times - the last appeal was to the Commissioner of Higher Education, no less. Everybody (me, doctor, Hill-Rom) wrote letters to appeal the denials. We sent the Hill-Rom back. This year, because my lung function was down, my doctor wanted to try again. We got SmartVest (Electromed) and InCourage (Respirtech) for trial periods - kept the InCourage and started the process of filing a claim with the new insurance provider. I was preparing for claim rejection and appeals (writing letters in my head, etc). Heard about a month ago that this year's company sent the claim NOT to outside reviewers (retired pulmonologists, in my opinion) but to the medical director of the insurance company, and it was approved. Nice surprise. Thankfully, we had the option of choosing another insurance carrier - which we actually did because it had lower premiums and still covered my out of state CF clinic care. Win Win???
Our insurance is through the state University system - with many plans to choose from. Last year's (more expensive) plan denied the Hill-Rom vest three times - the last appeal was to the Commissioner of Higher Education, no less. Everybody (me, doctor, Hill-Rom) wrote letters to appeal the denials. We sent the Hill-Rom back. This year, because my lung function was down, my doctor wanted to try again. We got SmartVest (Electromed) and InCourage (Respirtech) for trial periods - kept the InCourage and started the process of filing a claim with the new insurance provider. I was preparing for claim rejection and appeals (writing letters in my head, etc). Heard about a month ago that this year's company sent the claim NOT to outside reviewers (retired pulmonologists, in my opinion) but to the medical director of the insurance company, and it was approved. Nice surprise. Thankfully, we had the option of choosing another insurance carrier - which we actually did because it had lower premiums and still covered my out of state CF clinic care. Win Win???
<div class="FTQUOTE"><begin quote>at least we have the option, SeanDavis. Those with your idealized socialized medicine have to pay cash... their governments don't even cover the Vest. </end quote></div>
Unless you have private insurance that will cover it. The government usually will not, but I had an eflow and a vest before, and with less trouble than most in the states. I also pay nothing for any f my medical care- drugs, doctors or equiptment.
Also, the vest is becoming more comming in canada. If you get a script and a note of nessescity, you *can* make the gov. pay for it. Most of the people complaining arn't working the system right- if you make enough noise you can get most things paid for, and cut down wait times.
Unless you have private insurance that will cover it. The government usually will not, but I had an eflow and a vest before, and with less trouble than most in the states. I also pay nothing for any f my medical care- drugs, doctors or equiptment.
Also, the vest is becoming more comming in canada. If you get a script and a note of nessescity, you *can* make the gov. pay for it. Most of the people complaining arn't working the system right- if you make enough noise you can get most things paid for, and cut down wait times.
<div class="FTQUOTE"><begin quote>at least we have the option, SeanDavis. Those with your idealized socialized medicine have to pay cash... their governments don't even cover the Vest. </end quote></div>
Unless you have private insurance that will cover it. The government usually will not, but I had an eflow and a vest before, and with less trouble than most in the states. I also pay nothing for any f my medical care- drugs, doctors or equiptment.
Also, the vest is becoming more comming in canada. If you get a script and a note of nessescity, you *can* make the gov. pay for it. Most of the people complaining arn't working the system right- if you make enough noise you can get most things paid for, and cut down wait times.
Unless you have private insurance that will cover it. The government usually will not, but I had an eflow and a vest before, and with less trouble than most in the states. I also pay nothing for any f my medical care- drugs, doctors or equiptment.
Also, the vest is becoming more comming in canada. If you get a script and a note of nessescity, you *can* make the gov. pay for it. Most of the people complaining arn't working the system right- if you make enough noise you can get most things paid for, and cut down wait times.
<div class="FTQUOTE"><begin quote>at least we have the option, SeanDavis. Those with your idealized socialized medicine have to pay cash... their governments don't even cover the Vest. </end quote></div>
Unless you have private insurance that will cover it. The government usually will not, but I had an eflow and a vest before, and with less trouble than most in the states. I also pay nothing for any f my medical care- drugs, doctors or equiptment.
Also, the vest is becoming more comming in canada. If you get a script and a note of nessescity, you *can* make the gov. pay for it. Most of the people complaining arn't working the system right- if you make enough noise you can get most things paid for, and cut down wait times.
Unless you have private insurance that will cover it. The government usually will not, but I had an eflow and a vest before, and with less trouble than most in the states. I also pay nothing for any f my medical care- drugs, doctors or equiptment.
Also, the vest is becoming more comming in canada. If you get a script and a note of nessescity, you *can* make the gov. pay for it. Most of the people complaining arn't working the system right- if you make enough noise you can get most things paid for, and cut down wait times.
<div class="FTQUOTE"><begin quote>at least we have the option, SeanDavis. Those with your idealized socialized medicine have to pay cash... their governments don't even cover the Vest. </end quote>
Unless you have private insurance that will cover it. The government usually will not, but I had an eflow and a vest before, and with less trouble than most in the states. I also pay nothing for any f my medical care- drugs, doctors or equiptment.
Also, the vest is becoming more comming in canada. If you get a script and a note of nessescity, you *can* make the gov. pay for it. Most of the people complaining arn't working the system right- if you make enough noise you can get most things paid for, and cut down wait times.
Unless you have private insurance that will cover it. The government usually will not, but I had an eflow and a vest before, and with less trouble than most in the states. I also pay nothing for any f my medical care- drugs, doctors or equiptment.
Also, the vest is becoming more comming in canada. If you get a script and a note of nessescity, you *can* make the gov. pay for it. Most of the people complaining arn't working the system right- if you make enough noise you can get most things paid for, and cut down wait times.
<div class="FTQUOTE"><begin quote>at least we have the option, SeanDavis. Those with your idealized socialized medicine have to pay cash... their governments don't even cover the Vest. </end quote>
<br />Unless you have private insurance that will cover it. The government usually will not, but I had an eflow and a vest before, and with less trouble than most in the states. I also pay nothing for any f my medical care- drugs, doctors or equiptment.
<br />Also, the vest is becoming more comming in canada. If you get a script and a note of nessescity, you *can* make the gov. pay for it. Most of the people complaining arn't working the system right- if you make enough noise you can get most things paid for, and cut down wait times.
<br />Unless you have private insurance that will cover it. The government usually will not, but I had an eflow and a vest before, and with less trouble than most in the states. I also pay nothing for any f my medical care- drugs, doctors or equiptment.
<br />Also, the vest is becoming more comming in canada. If you get a script and a note of nessescity, you *can* make the gov. pay for it. Most of the people complaining arn't working the system right- if you make enough noise you can get most things paid for, and cut down wait times.
Lauren,
First, let me say, I'm so sorry! We all know this doesn't make sense.
My first (and only) vest was the SmartVest I got 18 months ago. My insurance denied the claim. The company (Electromed) contacted me and told me to keep the vest and they would keep fighting for payment. I don't know if they ever got paid, but I still have my vest and haven't heard anything else from Electromed.
Like so many above, my advice is contact Respirtech. Heck, contact Dr Warwick and explain your situation. Maybe he can write a letter on your behalf about the benefits of the Respirtech. Good luck Lauren. I'll be looking for an update, and I hope it's a happy one. Keep smilin'!
First, let me say, I'm so sorry! We all know this doesn't make sense.
My first (and only) vest was the SmartVest I got 18 months ago. My insurance denied the claim. The company (Electromed) contacted me and told me to keep the vest and they would keep fighting for payment. I don't know if they ever got paid, but I still have my vest and haven't heard anything else from Electromed.
Like so many above, my advice is contact Respirtech. Heck, contact Dr Warwick and explain your situation. Maybe he can write a letter on your behalf about the benefits of the Respirtech. Good luck Lauren. I'll be looking for an update, and I hope it's a happy one. Keep smilin'!
Lauren,
First, let me say, I'm so sorry! We all know this doesn't make sense.
My first (and only) vest was the SmartVest I got 18 months ago. My insurance denied the claim. The company (Electromed) contacted me and told me to keep the vest and they would keep fighting for payment. I don't know if they ever got paid, but I still have my vest and haven't heard anything else from Electromed.
Like so many above, my advice is contact Respirtech. Heck, contact Dr Warwick and explain your situation. Maybe he can write a letter on your behalf about the benefits of the Respirtech. Good luck Lauren. I'll be looking for an update, and I hope it's a happy one. Keep smilin'!
First, let me say, I'm so sorry! We all know this doesn't make sense.
My first (and only) vest was the SmartVest I got 18 months ago. My insurance denied the claim. The company (Electromed) contacted me and told me to keep the vest and they would keep fighting for payment. I don't know if they ever got paid, but I still have my vest and haven't heard anything else from Electromed.
Like so many above, my advice is contact Respirtech. Heck, contact Dr Warwick and explain your situation. Maybe he can write a letter on your behalf about the benefits of the Respirtech. Good luck Lauren. I'll be looking for an update, and I hope it's a happy one. Keep smilin'!
Lauren,
First, let me say, I'm so sorry! We all know this doesn't make sense.
My first (and only) vest was the SmartVest I got 18 months ago. My insurance denied the claim. The company (Electromed) contacted me and told me to keep the vest and they would keep fighting for payment. I don't know if they ever got paid, but I still have my vest and haven't heard anything else from Electromed.
Like so many above, my advice is contact Respirtech. Heck, contact Dr Warwick and explain your situation. Maybe he can write a letter on your behalf about the benefits of the Respirtech. Good luck Lauren. I'll be looking for an update, and I hope it's a happy one. Keep smilin'!
First, let me say, I'm so sorry! We all know this doesn't make sense.
My first (and only) vest was the SmartVest I got 18 months ago. My insurance denied the claim. The company (Electromed) contacted me and told me to keep the vest and they would keep fighting for payment. I don't know if they ever got paid, but I still have my vest and haven't heard anything else from Electromed.
Like so many above, my advice is contact Respirtech. Heck, contact Dr Warwick and explain your situation. Maybe he can write a letter on your behalf about the benefits of the Respirtech. Good luck Lauren. I'll be looking for an update, and I hope it's a happy one. Keep smilin'!
Lauren,
First, let me say, I'm so sorry! We all know this doesn't make sense.
My first (and only) vest was the SmartVest I got 18 months ago. My insurance denied the claim. The company (Electromed) contacted me and told me to keep the vest and they would keep fighting for payment. I don't know if they ever got paid, but I still have my vest and haven't heard anything else from Electromed.
Like so many above, my advice is contact Respirtech. Heck, contact Dr Warwick and explain your situation. Maybe he can write a letter on your behalf about the benefits of the Respirtech. Good luck Lauren. I'll be looking for an update, and I hope it's a happy one. Keep smilin'!
First, let me say, I'm so sorry! We all know this doesn't make sense.
My first (and only) vest was the SmartVest I got 18 months ago. My insurance denied the claim. The company (Electromed) contacted me and told me to keep the vest and they would keep fighting for payment. I don't know if they ever got paid, but I still have my vest and haven't heard anything else from Electromed.
Like so many above, my advice is contact Respirtech. Heck, contact Dr Warwick and explain your situation. Maybe he can write a letter on your behalf about the benefits of the Respirtech. Good luck Lauren. I'll be looking for an update, and I hope it's a happy one. Keep smilin'!
Lauren,
<br />
<br />First, let me say, I'm so sorry! We all know this doesn't make sense.
<br />
<br />My first (and only) vest was the SmartVest I got 18 months ago. My insurance denied the claim. The company (Electromed) contacted me and told me to keep the vest and they would keep fighting for payment. I don't know if they ever got paid, but I still have my vest and haven't heard anything else from Electromed.
<br />
<br />Like so many above, my advice is contact Respirtech. Heck, contact Dr Warwick and explain your situation. Maybe he can write a letter on your behalf about the benefits of the Respirtech. Good luck Lauren. I'll be looking for an update, and I hope it's a happy one. Keep smilin'!
<br />
<br />First, let me say, I'm so sorry! We all know this doesn't make sense.
<br />
<br />My first (and only) vest was the SmartVest I got 18 months ago. My insurance denied the claim. The company (Electromed) contacted me and told me to keep the vest and they would keep fighting for payment. I don't know if they ever got paid, but I still have my vest and haven't heard anything else from Electromed.
<br />
<br />Like so many above, my advice is contact Respirtech. Heck, contact Dr Warwick and explain your situation. Maybe he can write a letter on your behalf about the benefits of the Respirtech. Good luck Lauren. I'll be looking for an update, and I hope it's a happy one. Keep smilin'!
Wow sorry to hear this, its terrible that insurance can do this kind of thing. I recnetly got a Respritech vest last oct. my insurance did cover all but 500 dollars or so. I would Appeal to the highest level of the insurance branch taht you can. Contact as many representatives from your insurance as possible. if you become a big enough thorn in their side tthey might see thigns yoru way. Absolutely have the Doctor fill out a Letter specifically stating that this is a medical device needed for life function, ruling out any cosmetic BS. Contact Respritech, they should help you out and contact the insurance as well and at least offer you some form of support. You also might want o contact a lawyer or attorney if you know 1 and get a legal perspective on this and see if there is somethign that can be done through the law. hope this helps.
Wow sorry to hear this, its terrible that insurance can do this kind of thing. I recnetly got a Respritech vest last oct. my insurance did cover all but 500 dollars or so. I would Appeal to the highest level of the insurance branch taht you can. Contact as many representatives from your insurance as possible. if you become a big enough thorn in their side tthey might see thigns yoru way. Absolutely have the Doctor fill out a Letter specifically stating that this is a medical device needed for life function, ruling out any cosmetic BS. Contact Respritech, they should help you out and contact the insurance as well and at least offer you some form of support. You also might want o contact a lawyer or attorney if you know 1 and get a legal perspective on this and see if there is somethign that can be done through the law. hope this helps.
Wow sorry to hear this, its terrible that insurance can do this kind of thing. I recnetly got a Respritech vest last oct. my insurance did cover all but 500 dollars or so. I would Appeal to the highest level of the insurance branch taht you can. Contact as many representatives from your insurance as possible. if you become a big enough thorn in their side tthey might see thigns yoru way. Absolutely have the Doctor fill out a Letter specifically stating that this is a medical device needed for life function, ruling out any cosmetic BS. Contact Respritech, they should help you out and contact the insurance as well and at least offer you some form of support. You also might want o contact a lawyer or attorney if you know 1 and get a legal perspective on this and see if there is somethign that can be done through the law. hope this helps.
Wow sorry to hear this, its terrible that insurance can do this kind of thing. I recnetly got a Respritech vest last oct. my insurance did cover all but 500 dollars or so. I would Appeal to the highest level of the insurance branch taht you can. Contact as many representatives from your insurance as possible. if you become a big enough thorn in their side tthey might see thigns yoru way. Absolutely have the Doctor fill out a Letter specifically stating that this is a medical device needed for life function, ruling out any cosmetic BS. Contact Respritech, they should help you out and contact the insurance as well and at least offer you some form of support. You also might want o contact a lawyer or attorney if you know 1 and get a legal perspective on this and see if there is somethign that can be done through the law. hope this helps.
Wow sorry to hear this, its terrible that insurance can do this kind of thing. I recnetly got a Respritech vest last oct. my insurance did cover all but 500 dollars or so. I would Appeal to the highest level of the insurance branch taht you can. Contact as many representatives from your insurance as possible. if you become a big enough thorn in their side tthey might see thigns yoru way. Absolutely have the Doctor fill out a Letter specifically stating that this is a medical device needed for life function, ruling out any cosmetic BS. Contact Respritech, they should help you out and contact the insurance as well and at least offer you some form of support. You also might want o contact a lawyer or attorney if you know 1 and get a legal perspective on this and see if there is somethign that can be done through the law. hope this helps.