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[difficulty getting to the mayo clinic]
Author: Cathy (---.proxy.aol.com)
Date: 05-10-02 11:53
Hi again.
Well, I was denied to go to the mayo clinic in March and had to cancell my appointments. I was told I could be serviced within my network for my HMO. I then was sent to Loyola University in Chicago. My illness is so rare, I had to see the Chief Of Pulmonology/lung transplantation. Well, she decided not to step on University of Wisconsin's toes and will not repeat any testing. She wants me to try an experimental drug for a disease I have been twice I have and told 4 times I don't have. HELLO? Is there anyone out there that knows how I can get to the Mayo Clinic and get it covered under my insurance. I have since filed an appeal to my HMO and to the Dept of Insurance for IL. My HMO states, they may deny it again, but would like to review all of my records from all three institutions.
I have heard it's against the law now for the HMO to deny your physician's request to send you someplace in or out of the network.
Well, I'm afraid with my case it's going to take an ambulance ride to get it covered, even though I am not guaranteed the trip north. I am so frustrated with all of it now. I am on oxygen 3 liters continuously now, my situation is deteriorating and the HMO is playing games. I could cry.
Anyone, with any suggestions....please let me know...
thanks!
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[Re: difficulty getting to the mayo clinic]
Author: s. beckley -moderator (---.dialup.mindspring.com)
Date: 05-10-02 12:13
Dear Cathy,
While you are waiting on the appeal (and figuring out how to speed that up), please check out the University of Chicago hospital and see if they have any specialist in your condition. They are cutting edge in many areas, so they may be helpful. a
ssuming they are "in" network.
There is a book that may give you some pointers "Outsmarting Managed Care" by Bruce A. Barron, MD.
And please call the HCMA office at 973-983-7429 to talk to Lisa about your situation.
Best wishes
Sarah
Author: Cathy (---.proxy.aol.com)
Date: 05-10-02 11:53
Hi again.
Well, I was denied to go to the mayo clinic in March and had to cancell my appointments. I was told I could be serviced within my network for my HMO. I then was sent to Loyola University in Chicago. My illness is so rare, I had to see the Chief Of Pulmonology/lung transplantation. Well, she decided not to step on University of Wisconsin's toes and will not repeat any testing. She wants me to try an experimental drug for a disease I have been twice I have and told 4 times I don't have. HELLO? Is there anyone out there that knows how I can get to the Mayo Clinic and get it covered under my insurance. I have since filed an appeal to my HMO and to the Dept of Insurance for IL. My HMO states, they may deny it again, but would like to review all of my records from all three institutions.
I have heard it's against the law now for the HMO to deny your physician's request to send you someplace in or out of the network.
Well, I'm afraid with my case it's going to take an ambulance ride to get it covered, even though I am not guaranteed the trip north. I am so frustrated with all of it now. I am on oxygen 3 liters continuously now, my situation is deteriorating and the HMO is playing games. I could cry.
Anyone, with any suggestions....please let me know...
thanks!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
[Re: difficulty getting to the mayo clinic]
Author: s. beckley -moderator (---.dialup.mindspring.com)
Date: 05-10-02 12:13
Dear Cathy,
While you are waiting on the appeal (and figuring out how to speed that up), please check out the University of Chicago hospital and see if they have any specialist in your condition. They are cutting edge in many areas, so they may be helpful. a
ssuming they are "in" network.
There is a book that may give you some pointers "Outsmarting Managed Care" by Bruce A. Barron, MD.
And please call the HCMA office at 973-983-7429 to talk to Lisa about your situation.
Best wishes
Sarah