Posted by allisonm on November 12, 2000, at 13:16:59
In reply to RE: s. Howards's response On the flip side ..., posted by Kaarina on November 12, 2000, at 12:54:33
> Would a HMO send a notice saying that they would refuse to pay? Or is this just for mental illnesses? > >I don't think it's limited to mental illness. I think they do this all the time elsewhere also. However, mental illness is harder to track/quantify results-wise, I think, so maybe they ARE pickier with us.
A little over two years ago, my pdoc also got a notice from my HMO saying "gee she's been on ADs for more than 6 months now, and we think most patients only need them for 6 mos. What's up?" Nevermind that my HMO doesn't pay for my scripts -- they are paid for by my major medical coverage, which is with another company entirely... We joked at the time, reasoning that the trials for ADs are only for 6 weeks, maybe the time limit for taking ADs should only be 6 weeks in the HMO rule book. That's probably next.
poster:allisonm
thread:2520
URL: http://www.dr-bob.org/babble/social/20001031/msgs/2576.html