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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File.


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Old 04-11-2007, 12:09 PM
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CindyLou CindyLou is offline
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Join Date: Mar 2007
Posts: 627
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Hi you guys,

Say, I'm just finding it very curious that I still have not received any "official" documentation, or phone call etc., from HealthPartners about my 2nd appeal denied. (other than hearsay from my husband's company, who said let HP decide and keep owner out of it) Technically, they are to respond w/i 30 days to me, which was last week. Now, my case manager from HP just called me to see how I was doing and had I heard yet (she claims not to have access to that information), and I said no, I haven't heard from HP. She thought it odd too, that I should have legally had a response w/i the 30 day time period as well. I'm wondering if I can use this to my advantage with the State of Minnesota Dept. of Health, as I request an external, 3rd party review? Don't you think this looks favorable to me, that as I'm filling out the paperwork and they say "enter a brief description of the claim, request, tx, and why it was denied," I can write: they never got back to me after 30 days. I don't know. Maybe I'm out on a limb here, hoping against hope. Any thoughts? Suggestions? Thanks.
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CindyLou
bicycle accident 6/19/01
2 compression fractures, T12, L1;
vertibroplasty @ above levels, 9/15/01
4/06 hip labral tear repair
4/07 Lumbar ProDisc replacement by Dr. B., 3 levels; L3-6
7/2/08 ALIF of L6-S1
7/30/08 Removed bone cement.
8/7/08 Diagnosed with pulmonary embolism, double pneumonia, collapsed left lung, pleurisy, pleural effusion.
3/10/09 right SI Joint Fusion; seeing light at end of tunnel, for first time in 8 years!!
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Old 04-11-2007, 12:39 PM
chasswen chasswen is offline
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Join Date: Apr 2006
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cindy
i would not worry about it untill you return home. and at that point you will be fixed and you will have a lost at that point.i am still going rounds with blue crap on out of network. they did apply a dr visit and back brace from germany towards my deductible. so i am still hopeful.
chuck
seems once theres a lost thing change some how. i am not getting down right turned down. so far
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ddd 1990
2003 mri,xrays,shots,emg
2004 discogram ouch pos l4 l5
facet block neg
lost all appeals BCBS 5 months of that
3 surgeons later
surgery with dr. bertagnoli aug 2nd 2006 in Bogen Germany Successfully ProDisc-L L-4 L-5
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  #3  
Old 04-11-2007, 05:42 PM
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CindyLou CindyLou is offline
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Join Date: Mar 2007
Posts: 627
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Chuck,

Is that a typo, or what is a lost? I don't know what you mean by that. Like it got lost in the mail? I'm confused.......
__________________
CindyLou
bicycle accident 6/19/01
2 compression fractures, T12, L1;
vertibroplasty @ above levels, 9/15/01
4/06 hip labral tear repair
4/07 Lumbar ProDisc replacement by Dr. B., 3 levels; L3-6
7/2/08 ALIF of L6-S1
7/30/08 Removed bone cement.
8/7/08 Diagnosed with pulmonary embolism, double pneumonia, collapsed left lung, pleurisy, pleural effusion.
3/10/09 right SI Joint Fusion; seeing light at end of tunnel, for first time in 8 years!!
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