Question for the group

[MOLEABE]

I am having Trouble

[BlakeJordan]

Not sure how far up the latter you've gotten, but I'd suggest trying a written/faxed/mailed/proof of delivery letter to your insistence company asking for reconsideration with your drs. Written letter of recommendation. Keep going up the chain until your able to get the contact info to get onto the medical directors of the insurance company/IPA. Make sure you have written notes from your dr, specialists, etc. concerning the specific recommendations and why the other basic accommodations are unacceptable. It may be beneficial to have contact info of the drs. Office in case files are in question, and releases if needed on file if need to make process as quick as possible. I'd suggest going straight to the top, and getting your claim in with the directors office for best luck with time. Finding that info may be Internet searching. Phone calls. Customer service etc. This info comes from my father- who was once a medical director for an IPA. Good luck! -Blake-

[MOLEABE]

Thanks Blake I will toot out who the devil is the head of Medicare and tear them a new one,and after tearing them a new one I'll leave them some nice european Diapers because they don't cover shit,think he will het the message.LOL

[BlakeJordan]

Remember that also there may need specific "appeal" forms filled out as well. Make sure you have those, along with your own material. And again-good luck. Insurance will defer, deny, and delay. However it's ultimately going to up to the medical director to make that call, and get you what you need Best, -Blake-

[rusty pins]

If all else fails, maybe try getting together all the information from your doctor stating your need medically for the catheters, then engage a lawyer for the purpose of sending notification to your insurance company that legal action will be taken on your behalf if they do not cover your medical needs per your doctor's instructions.

[sarah_ab]

what do catheters have to do with your arm?

[Dill_Pickle]

Sarah is, un.fortunately, right....that first paragraph leaves us guessing...I hope it isn't a sign you are not OK medically...

[BlakeJordan]

Having issues with hands myself. I am guessing catheters are extremely difficult with limited dexterity. The limited use of a hand, can be detrimental in using caths day to day. One might be able to manage in an emergency. But for everyday use, it's nearly unpractical without full use of two working hands. -Blake-

[MOLEABE]

My apologies for the typos, My brain is still scrambled from my "little" Incident i was found Dead in Bed and resuscitated from there i fell into a week long Coma and vegetated in ICU, so I may not be all there yet but i'm working on it!!

[Bettypooh]

Check your policy for coverage, then use your limited ability to explain that you need pull-up diapers because you can't self-help otherwise. If they object, then demand a caretaker be assigned to do it for you In comparison the diapers will be cheap so that's what they will go for

[rusty pins]

My apologies for the typos, My brain is still scrambled from my "little" Incident i was found Dead in Bed and resuscitated from there i fell into a week long Coma and vegetated in ICU, so I may not be all there yet but i'm working on it!!

[Red Barchetta]

I'm not sure I'm 100% positive of the point.. HOWEVER -

On top of I diaper, I use a straight catheter 3 times a day..Actually Medicare dose not pay for either, and I don't either (well unless I want something that costs more than secondary insurance is willing to pay).