Forum: The Big File
12-22-2005, 01:15 PM
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Replies: 28
Views: 20,146
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Forum: The Big File
11-08-2005, 05:41 PM
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Replies: 5
Views: 11,528
Hi,
UHC approved my upcoming one-level ADR,...
Hi,
UHC approved my upcoming one-level ADR, but only because they were forced to. MD-IPA, which is operated by UHC, had to cover mine since I'm a member of a Federal Employee health plan and they...
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Forum: The Big File
08-24-2005, 12:38 PM
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Replies: 8
Views: 12,632
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Forum: The Big File
08-23-2005, 10:03 PM
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Replies: 8
Views: 12,632
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Forum: The Big File
07-18-2005, 11:03 AM
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Replies: 11
Views: 11,287
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Forum: The Big File
06-28-2005, 03:08 PM
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Replies: 9
Views: 9,000
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Forum: The Big File
06-24-2005, 03:33 PM
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Replies: 24
Views: 33,507
Kristi/Kat,
MAMSI, which is owned by UHC,...
Kristi/Kat,
MAMSI, which is owned by UHC, denied my appeal, and I'm pretty sure they never even bothered to read it. In my appeal I told MAMSI that Federal regulations prevented them from...
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Forum: The Big File
06-17-2005, 10:10 AM
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Replies: 9
Views: 9,499
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Forum: The Big File
06-16-2005, 07:33 PM
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Replies: 93
Views: 92,006
FWIW...
My doc has told me that UHC has been...
FWIW...
My doc has told me that UHC has been the worst when it comes to approving ADR. I have MAMSI, which is owned by UHC, and I don't believe they even looked at my appeal before they denied...
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Forum: The Big File
06-10-2005, 10:41 AM
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Replies: 5
Views: 6,115
Rein,
You may be right. She was definitely...
Rein,
You may be right. She was definitely not hitting on all cylinders. http://adrsupport.org/groupee_common/emoticons/icon_wink.gif The thing that *really* gets me is that MAMSI isn't...
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Forum: The Big File
06-09-2005, 03:19 PM
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Replies: 5
Views: 6,115
Well, the saga continues. My appeal was denied...
Well, the saga continues. My appeal was denied by MAMSI, again using the "experimental" label. I haven't seen their formal response yet, but I received a "courtesy" call from their appeal "auditor"...
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Forum: The Big File
05-19-2005, 08:19 PM
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Replies: 4
Views: 10,238
It seems to me, as I may have mentioned before,...
It seems to me, as I may have mentioned before, that the thing to do is to get a law passed that prohibits carriers from claiming something that's been FDA approved is "experimental." It seems to me...
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Forum: The Big File
05-17-2005, 09:21 PM
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Replies: 3
Views: 6,394
I received a copy of my radiologist's report...
I received a copy of my radiologist's report today to use for my appeal. The goal of my appeal is to demonstrate that I meet the indications as stated by the FDA, and one of those conditions is...
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Forum: The Big File
05-16-2005, 05:34 PM
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Replies: 6
Views: 5,796
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Forum: The Big File
05-16-2005, 12:05 PM
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Replies: 6
Views: 5,796
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Forum: The Big File
05-11-2005, 07:34 PM
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Replies: 5
Views: 8,925
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Forum: The Big File
04-28-2005, 12:16 PM
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Replies: 15
Views: 12,948
Forgot to mention that my original question has...
Forgot to mention that my original question has become somewhat moot. Since I'm covered under the Federal Employee Health Benefits (FEHB) Plan, my insurance carrier, by law, cannot declare anything...
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Forum: The Big File
04-28-2005, 12:11 PM
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Replies: 15
Views: 12,948
Hi,
In answer to Brady's question as to...
Hi,
In answer to Brady's question as to where I am in the authorization process is: I don't know. http://adrsupport.org/groupee_common/emoticons/icon_wink.gif I *think* that my...
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Forum: The Big File
04-24-2005, 09:55 PM
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Replies: 6
Views: 9,034
Kim,
make the sure the plan documentation...
Kim,
make the sure the plan documentation doesn't have the definition of investigational and experimental in it already - I know the my MAMSI plan has it listed in their defintions. Also search...
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Forum: The Big File
04-24-2005, 07:48 PM
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Replies: 6
Views: 9,034
Kim,
I'm new to the appeal procedure - I'm...
Kim,
I'm new to the appeal procedure - I'm hoping I won't have to appeal, but I'm already getting my guns lined up - but here are my thoughts.
First, keep your letter professional. The less...
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Forum: The Big File
04-23-2005, 09:49 AM
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Replies: 5
Views: 9,182
Robin,
Here are the facts, based on the FEHB...
Robin,
Here are the facts, based on the FEHB letter I posted. If your insurance is held through the FEHB program, they cannot classify anything that has been FDA approved as "experimental" or...
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Forum: The Big File
04-22-2005, 07:55 PM
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Replies: 7
Views: 12,808
Hi,
Sorry you had problems with McAfee's...
Hi,
Sorry you had problems with McAfee's office. I have a feeling they're beaten down over the insuarnce fights and are tired of it, and I can't really blame them. As far as whose responsibility...
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Forum: The Big File
04-22-2005, 06:48 PM
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Replies: 5
Views: 9,182
Hi all,
I don't know if this is known by the...
Hi all,
I don't know if this is known by the group or not, but anyone covered under the Federal Employee Health Benefits Plan (FEHB) cannot be denied coverage for the Charite ADR, provided it...
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Forum: The Big File
04-22-2005, 03:45 PM
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Replies: 15
Views: 12,948
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Forum: The Big File
04-22-2005, 02:42 PM
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Replies: 15
Views: 12,948
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