• 0 Posts
  • 17 Comments
Joined 1 year ago
cake
Cake day: June 23rd, 2023

help-circle







  • I’m not sure your last sentence is entirely accurate. He’s white-ish (orange would be more accurate), rich-ish (highly overleveraged), and connected-ish (those that are not in prison are jumping ship).

    Willing to concede the white/orange portion, but for a man who allegedly is worth billions he’s having trouble scraping together enough money for bond. Those connections wouldn’t even step up to post it for him or loan him the money to post.







  • I speak from experience. Blue Cross has not argued or denied any of our doctors’ requests since the second time I used that method.
    Had a specialist tell my wife she needed a shoulder replacement. Insurance wanted her to do physical therapy. I was livid. “I want the license number of the doctor on your end who is deciding that physical therapy is going to some how magically fix torn rotator cuff tendons. Telling our medical specialist that physical therapy is required is a medical decision that contradicts their diagnosis that it needs replaced. If we follow your recommendation and it fails, I need the name and license number of who to go after for making that decision. Shielding this professional, and I use that term loosely, indicates that you’re willing to assume all the liability when “physical therapy” causes more pain and damage.”


  • LPT: If your doctor firmly believes that you require X treatment/medication/etc. Have them use the specific term “medically necessary”. If your insurer kicks it back with that phrasing attached, contact them. Ask for the medical license number of the doctor who indicated that it was not medically necessary. Push for this information (they won’t have it) and continue the line of “Someone on your end is making a medical decision against my doctors orders. I require their credentials so I can confirm they are a) qualified to make medical decisions, and b) have a higher education that my doctor possesses.”