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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Julie on October 11, 2000, at 15:43:16
My insurance company just decided to limit my therapy visits to 20 per year, even though they've been covering weekly visits for the past 2 years.
On paper, the plan covers 20 visits a year for "mental illness" but if you have a severe mental illness, including major depression, you theoretically have unlimited visits. My diagnosis is major depression, severe, recurrent-- one really nasty spell 8 years ago and a few shorter ones since; most of the time, thanks to meds and therapy, I'm fine. But I'm scared about only having therapy every 2 or 3 weeks... and angry that the insurer would do this. My therapist pointed out to them that in the summers of 98 and 99 I landed in the hospital for a couple of days each, but they didn't budge. I went to the Human Resources office at my job, and they were massively unhelpful-- they didn't even have the most recent copy of the insurance plan.
Anyone have experience appealing this kind of thing?
Thanks for your input--
Posted by quilter on October 14, 2000, at 0:06:46
In reply to d-mn insurance companies!, posted by Julie on October 11, 2000, at 15:43:16
We have run into this problem each of the past 4 or 5 years. our insurance pays for 26 visits but when things go especially well I can't seem to keep it below every other week. We have to have both pdoc and therapist write letters to the insurers explaining the necessity for additional visits. The extensions have always been granted through a program called case benefits management. I'm afraid I don't know what exactly the docs have had to say in their letters. Try to talk to the person in the clinic you visit who handles their insurance claims. You are not the first person to have to jump through this particular hoop so s/he should be able to help you and your providers figure out what has to be said and how.
Quilter
Posted by Julie on October 14, 2000, at 18:50:02
In reply to Re: d-mn insurance companies! » Julie, posted by quilter on October 14, 2000, at 0:06:46
Quilter- yeah, sounds like how my program works. My therapist has been writing these letters and getting extensions for awhile, apparently-- I don't know why the claims people stopped approving them--
Posted by laural on October 19, 2000, at 7:44:12
In reply to Re: d-mn insurance companies!, posted by Julie on October 14, 2000, at 18:50:02
i want to share with you a hate letter i emailed my insurance co.a little while ago. i know it was childish but i was sooooo angry and it really made me feel better to vent, even at the expense of someone elses good day--
To whom it may concern or not
I have been on your f@!#*ing phone tree for the past 2 f@!#*ing hours now. I've talked to someone at the number 18009652583 in order to get authorization to see a psychiatrist and was told to then call 18009324480 ext.64579 because I wasn't listed. This is not what is bothering me, however. What bothers me is that I had to sit with the phone pressed to my ear listening to a recorded voice telling me how godd-mn important I was and that she was sorry I had to wait for two HOURS. If you guys are so f@!#*ing sorry, hire some more godd-mn phone operators and abandon your f@!#*ing phone tree. I don't believe your sincerity. Stop being so f@!#*ing patronizing. I was told I needed to call in order to request more time than you were otherwise willing to pay for in order to get the attention I deserve and frankly NEED in order to save my life. You obviously don't give a shi^t in so many ways. Seeing as how you are the only people I can get to insure me, that gives you a monopoly on my life and so I might not be of priority, but if you answer to anyone other than Satan himself--please make it possible for me to access you without having to bend over. By the way, there is no way to even enter the aformentioned extension number to get whomever I supposedly need. Sincerely, a client
it may or may not amuse, i know its not my #1 grievance with insurance but --
Posted by noa on October 19, 2000, at 15:55:53
In reply to Funny (?) hate letter, posted by laural on October 19, 2000, at 7:44:12
LOVE IT.
I recently had a similar experience with my local AND long distance companies--7 calls over a two hour period, shuffled from one person to the next, disconnected, unable to get them to talk to each other about why the long distance was not in effect, etc. Afterward, I thought I might send them a bill for my time!!! It is what I call "TELEMISCOMMUNICATION" and "CUSTOMER DISsERVICE".
My celphone company also keeps me on hold over an hour with that ridiculous tape saying how much they value my business and how important I am etc. It is easy to say things like that, but I would like them to act it.
I am especially irked at the cellphone companies because they are constantly doing big promotions to sign up more and more customers but the services gets worse and worse. Every Friday afternoon, for example, for about 2-4 hours, it is impossible to make or receive any calls because "the network is busy". When I finally reached customer disservice, I complained about it and the response was "well I guess you live in a busy area". That is correct, but it seems unacceptable to me to be bringing in more customers if you cannot properly serve the existing ones.
I know that the economy and low unemployment adds to the erosion of good customer service (have you asked questions about products in stores lately only to get that blank stare and the "I don't know", which, by the way, is a much better answer than the frequent make-it-up-just-to-shut-the-customer-up kind of answer). However, I think there has been a definite abandonment of the VALUE of good service by the companies, a neglect of good training. This attention to good service seemed to be a trend in the eighties and early nineties, and I wondered what happened to that trend? Is it that in a good economy the companies know people are going to spend money anyway? It bothers me a lot.
Laural, all of this is not to overlook my particular irritation at insurance companies and so called "managed care"---really it is "managed cost" (not my own idea, I learned this from the Coalition for Mental Health Consumers and Professionals (www.nomanagedcare.com).
So, thanks for sharing that letter. It was great.
Posted by Julie on October 19, 2000, at 20:46:08
In reply to Funny (?) hate letter, posted by laural on October 19, 2000, at 7:44:12
Great letter! The Satan/bend over line is especially priceless-- I'm glad you had the guts to send it! (and the wit to write it-!)
This is the end of the thread.
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