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RT payments...Compiling a List of Insurance Codes
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03/04/2011 22:45
LubaM. 
03/04/2011 22:45
LubaM. 
RT payments...Compiling a List of Insurance Codes

As many of you know, there has been lots of discussion about problems with Medicare and insurance companies NOT paying for RT treatments. It would be helpful to all, if a list is available with all the Codes, from people whose insurance have paid for RT treatments. Rather than looking on the Forum all over the place....here's an idea.....

I am willing to compile such a list and then post it on this Forum for everyone to benefit from.

IF your insurance has paid for RT, please send me a Private Message on this Forum...click on "Private Messages" on the upper right corner, put in my name "LubaM.", and send me the Codes (I already have the information from Lori)..... I will compile the list and then post the list.

03/06/2011 04:17
flojo 
03/06/2011 04:17
flojo 
Re: RT payments...Compiling a List of Insurance Codes

Good idea. I have started saving the codes that I picked up from various posts and have them in a Word document. Thought I would need them with the Medicare appeal. If it's OK, I will call you tomorrow sometime to strategize. I also have a couple of questions about your insurance Explanation of Benefits before I go forward.

03/06/2011 11:55
Larry 
03/06/2011 11:55
Larry 
Re: RT payments...Compiling a List of Insurance Codes

I could try to get the comparable codes from the German system just for comparison ...

03/06/2011 21:26
flojo 
03/06/2011 21:26
flojo 
Re: RT payments...Compiling a List of Insurance Codes

Larry,

Never know. German codes might help.

Thanks

03/06/2011 23:40
LubaM. 
03/06/2011 23:40
LubaM. 
Re: RT payments...Compiling a List of Insurance Codes

flojo:
Larry,

Never know. German codes might help.

Thanks
Larry,
Send me a private message with the codes or post them here...I will add them to the list I'm compiling.

Luba

Edited 03/07/11 17:29

03/07/2011 21:33
lauriw 
03/07/2011 21:33
lauriw 
Re: RT payments...Compiling a List of Insurance Codes

I just found out that I won my appeal with BCBS of Iowa for RT for my DD. You have to be very involved and aggressive with your appeals. First find out why they denied the treatment. If they say it's not medically necessary that is a good place to start. It might be helpful to find out when Medicare stopped paying for RT. Don't give up!
LauriW

03/07/2011 23:13
LubaM. 
03/07/2011 23:13
LubaM. 
Re: RT payments...Compiling a List of Insurance Codes

lauriw:
I just found out that I won my appeal with BCBS of Iowa for RT for my DD. You have to be very involved and aggressive with your appeals. First find out why they denied the treatment. If they say it's not medically necessary that is a good place to start. It might be helpful to find out when Medicare stopped paying for RT. Don't give up!
LauriW
LauriW,
Happy to hear you won your appeal. Flora (Flojo) is in the midst of contacting Medicare and Scripps Hospital to find out about the denials. Because Flora and myself are both on Medicare, they have to pay first before our Anthem Blue Cross PPO agrees to pay as secondary insurance. If Medicare denies, Anthem won't pay either.

Maybe it works different when you are not on Medicare and your Insurance Co. is the one to deny the claim... We'll see what Flora comes up with.

LauriW...would you mind sending me the RT Treatment Codes that BCBS had on their forms, especially now that they approved, so that I can add them to the list I am compiling for future posting on this forum.

03/08/2011 01:08
lauriw 
03/08/2011 01:08
lauriw 
Re: RT payments...Compiling a List of Insurance Codes

My codes are pretty much like everyone else and since I have not had the RT yet I don't have a copy of what actually will get billed, when I do I will share all of those. I don't think the codes are the only thing that is important. You have to provide documentation that RT is Medically Necessary. Find out if Medicare specifically states that it does not pay for DD with RT. If that is not the case you have to build a case with your doctor on medical necessity and prove that this has become a standard of treatment in the US. That's why I worked so hard to find out what insurance policies and where had paid for RT. I think that is what won my case as well as letters to everyone, insurance commission and lawyers as well. Put the pressure on!
LauriW

03/08/2011 23:54
Gwen

not registered

03/08/2011 23:54
Gwen

not registered

Re: RT payments...Compiling a List of Insurance Codes

Luba,

I will see if I can still access my insurance codes online from my RT treatments at Scripps. But I tend to agreed that it might not just be the codes that are being used. I only have my primary insurance coverage, and while it took a week for pre-approval they covered 100% of the costs. It should be mentioned that while my provider is United Healthcare, my company self insuraces through them.

Gweneth

03/09/2011 05:03
LubaM. 
03/09/2011 05:03
LubaM. 
Re: RT payments...Compiling a List of Insurance Codes

@Gwen:
Luba,

I will see if I can still access my insurance codes online from my RT treatments at Scripps. But I tend to agreed that it might not just be the codes that are being used. I only have my primary insurance coverage, and while it took a week for pre-approval they covered 100% of the costs. It should be mentioned that while my provider is United Healthcare, my company self insuraces through them.

Gweneth
Gweneth,

I think the problem is with Medicare....and in my case (as well as Flora's) because Medicare is primary for us, then Anthem Blue Cross (secondary insurance) doesn't pay if Medicare doesn't pay. We really need to work with doctors and have them write the necessary letters for the appeal to Medicare.

Thanks, I appreciate your trying to get the codes. When did you have your treatments at Scripps?

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