another question

Has anyone on the list ever been denied by their insurance
company  
for a second opinion?

I just heard this and wonder if this is because it is IBC or
if this  
is norm?

My daughter did not have this problem.

If this is happening, is there a work around?  If it is only
with IBC  
it sounds discriminatory.

Patti



patti bradfield
Redmond, WA
www.phbservices.com





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I have never heard of this, and I used to work for an
insurance company. My
bet is that the doctor's office failed to code it as a
second opinion, and
when the insurance company got the claim, it looked like a
duplication of
services. The patient should contact the insurance company
and find out why
the claim was denied. Insurance companies normally encourage
second surgical
opinions, as it saves them money should they patient decide
against surgery.

Susan

-----Original Message-----
From: ibc-bouncesibcsupport.org [mailto:ibc-bouncesibcsupport.org] On
Behalf Of patti bradfield
Sent: Wednesday, November 29, 2006 3:30 PM
To: IBC Support Group
Subject: [ibc] another question

Has anyone on the list ever been denied by their insurance
company  
for a second opinion?

I just heard this and wonder if this is because it is IBC or
if this  
is norm?

My daughter did not have this problem.

If this is happening, is there a work around?  If it is only
with IBC  
it sounds discriminatory.

Patti



patti bradfield
Redmond, WA
www.phbservices.com





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Good question and I'll be anxious to see the replies on
this... I immediately thought this may be a part of the type
of insurance one has - traditional do as you please without
consents or referrals verses the HMO type where you need the
referral and someone else is in the control seat of sending
you etc.....
Barbara in NJ 
 
 
-----Original Message-----
From: p.thewriterverizon.net
To: ibcibcsupport.org
Sent: Wed, 29 Nov 2006 3:30 PM
Subject: [ibc] another question


Has anyone on the list ever been denied by their insurance
company  
for a second opinion?

I just heard this and wonder if this is because it is IBC or
if this  
is norm?

My daughter did not have this problem.

If this is happening, is there a work around?  If it is only
with IBC  
it sounds discriminatory.

Patti



patti bradfield
Redmond, WA
www.phbservices.com





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The issue might be where the second opinion was.  My HMO
approved my
visit to a big cancer center a thousand miles away to get a
second
opinion, but it took a little more effort because it was out
of
network.  Then later the paperwork got messed up, and I had
to fight
my way through the telephone tree to get it straightened
out.

But Susan's comment that insurance companies usually support
second
opinions is usually true, especially for something rare and
deadly
like ibc.

Phyllis in Concord, NC

On 11/29/06, Susan Bumgarner <susanwbcharter.net> wrote:
> I have never heard of this, and I used to work for an
insurance company. My
> bet is that the doctor's office failed to code it as a
second opinion, and
> when the insurance company got the claim, it looked
like a duplication of
> services. The patient should contact the insurance
company and find out why
> the claim was denied. Insurance companies normally
encourage second surgical
> opinions, as it saves them money should they patient
decide against surgery.
>
> Susan
>
> -----Original Message-----
> From: ibc-bouncesibcsupport.org [mailto:ibc-bouncesibcsupport.org] On
> Behalf Of patti bradfield
> Sent: Wednesday, November 29, 2006 3:30 PM
> To: IBC Support Group
> Subject: [ibc] another question
>
> Has anyone on the list ever been denied by their
insurance company
> for a second opinion?
>
> I just heard this and wonder if this is because it is
IBC or if this
> is norm?
>
> My daughter did not have this problem.
>
> If this is happening, is there a work around?  If it is
only with IBC
> it sounds discriminatory.
>
> Patti
>
>
>
> patti bradfield
> Redmond, WA
> www.phbservices.com
>
>
>
>
>
> [list software deleted text/html attachment]
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I think there are two sides to this one: First, if you are
in a managed care that needs referrals, then the referral
would have to be to an in-network Doc.  If you have a choice
of in or out of network Docs, then you may be responsible
for only part of the  "out of Net" Doc's bill.  A
larger part then if you had stayed in-net.  
 
  We were in an Aetna EPO when Doracina was diagnosed.  We
were going to an in-net Doc with an in-net Onc.  Wanted a
second opinion from Sloan.  Soon as Sloan heard the magic
word "Aetna" they told me to take a hike.  We
ended up with a second opinion form an out-of -net Doc. at
Sloan.  Because we were not referred to this Doc. we foot
the bill. 
 
There are a whole lotta little things that can hang you up
on insurance.  My favorite was the R.A.P.s  stipulation my
company had written into our insurance.   Took a year for me
to lose my fight on that one.  Ha Ha!!! 
 
Anyhow, I do not think the IBC Diagnosis had anything to do
with it. We went out of Net. and that was that. 
 
Rich in NJ
----- Original Message -----
From: patti bradfield 
Date: Wednesday, November 29, 2006 3:31 pm
Subject: [ibc] another question
To: IBC Support Group 

> Has anyone on the list ever been denied by their
insurance 
> company 
> for a second opinion?
> 
> I just heard this and wonder if this is because it is
IBC or if 
> this 
> is norm?
> 
> My daughter did not have this problem.
> 
> If this is happening, is there a work around? If it is
only 
> with IBC 
> it sounds discriminatory.
> 
> Patti
> 
> 
> 
> patti bradfield
> Redmond, WA
> www.phbservices.com
> 
> 
> 
> 
> 
> [list software deleted text/html attachment]
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> ** Information - subscribe, unsubscribe, archives,
etc.:
> ** http://www.ibcsupport
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> 

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