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denied coverage

Posted by Chris D. on 5/08/02 at 21:20 (083147)

HealthPartner's coverage in Minnesota does not allow for ESWT, I was informed by a very cheerful sounding nurse this afternoon. She probably was worried I would take my frustration out on her, but the chipper way she gave me the bad news was a bit weird. I will appeal the decision with the idea that future patients will someday benefit. I will also look into having this non-invasive therapy done somewhere and paid for by ME before I resort to the surgery that was advised for me. are we pioneers?

Re: denied coverage

Mary Beth S on 5/09/02 at 05:52 (083186)

Find out why it was denied and get it in writing before you begin your appeals process. The same thing was told to me at Tufts until I insisted that they send the claim to be reviewed and processed by an orthopedic and or podiatric doctor. The nurse that I spoke with couldn't even pronounce the word let alone understand what the procedure was. It's essential to get something in writing, find out what procedure code they denied the claim against and why. Good luck. MB

Re: denied coverage

Chris D. on 5/09/02 at 20:12 (083295)

Thank you for the tips Mary Beth. I will make sure to use them.

Re: denied coverage

Mary Beth S on 5/09/02 at 05:52 (083186)

Find out why it was denied and get it in writing before you begin your appeals process. The same thing was told to me at Tufts until I insisted that they send the claim to be reviewed and processed by an orthopedic and or podiatric doctor. The nurse that I spoke with couldn't even pronounce the word let alone understand what the procedure was. It's essential to get something in writing, find out what procedure code they denied the claim against and why. Good luck. MB

Re: denied coverage

Chris D. on 5/09/02 at 20:12 (083295)

Thank you for the tips Mary Beth. I will make sure to use them.