TC - you may be right, but I'm gun shy around insurance companies. I've had a couple of memorable battles about
small no-brainer claims that should have been paid without me having to engage in months of correspondence, phone calls, copies of documents I'd previously sent, etc. One of these claims was for my wife's routine annual physical. My employer's insurer in Texas (a local branch of a very well know insurer with branches in every state) denied payment claiming it was coded wrong. My wife's doctor's offce - a member of a group practice directly attached to our teaching hospital-insisted it was coded correctly -- using the same codes that are accepted by the Massachusetts affiliate of the very same insurer.
If this had been just one incident I'd chalk it up as bad luck. But I can think of three other similar battles that I ultimately won only by badgering medical insurers into submission.
-DX March 2002 - PSA 9.4, needle biopsy PCa 75% left lobe.Small focus right.
-RP April 2002. Pathology PT3B N0 MX Gleason=7 (3+4), seminal vesicle involvement. No lymph node involvement.
-Post-surgery PSA low of 0.01; slow rise to 0.4 (August 2009).
-SRT Jan/Feb 2010. Enlarged lymph node near prostate bed targeted. Casodex 3 months during SRT
-PSA 0.00 Jan 2013
Post Edited (Bohemond) : 7/31/2013 9:58:43 AM (GMT-6)