#10444 - 04/16/04 01:41 PM
Re: small important step...
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Member
Registered: 08/11/03
Posts: 30
Loc: Philadelphia, pa
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yes James, i'm ready for that hard fight as well. why quit when i'm ahead, right! One question on that would be, should i get that letter from 1. my primary care doc. 2. my ob/gyn or 3. my Endocrinologist. (or all 3). And of course the letter should explain that electrology will be a perscription to treat hirtuism (sorry for spelling). correct? no?
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#10445 - 04/16/04 09:05 PM
Re: small important step...
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Top 10 Contributor
Registered: 06/03/02
Posts: 4886
Loc: Buffalo NY, & Traveling the US...
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You have the idea. If you can swing it, get all of your doctors to prescribe electrolysis. It should also be noted that the hair removal is not only a treatment for hirsutism, but that it is an integral part of both your medical team's diagnostic and treatment plan. It is impossible to know if the medication to arrest your systemic problems are working without removing the previously grown hair.
Remember to keep all originals (have your doctor create two originals, one sent to you, and the other to the insurance company) and send everything certified mail, so someone has to sign for it, and you get a return receipt for each item you mail
They will try to say that they never got anything you sent, or that it was lost in the office, or some such nonsense. If you are always able to produce another copy, they will have to change stall tactics.
Later, when you are suing them, you will have proof of your compliance with their notifications and their stall tactics.
It won't be easy, but it will be worth it.
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#10446 - 04/20/04 09:09 AM
Re: small important step...
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Member
Registered: 08/11/03
Posts: 30
Loc: Philadelphia, pa
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thanks James...i appreciate your help as many of us do on this board. In the future, if i have any more questions or concerns, i hope you don't mind helping me out! I know it will not be easy, nothing has been from dealing to treating this syndrome (or whatever you call it)...but i've lasted this long and I'm in no way ready to quit! I will, of couse, post my progress and any referrals that i have.
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#10447 - 06/02/04 11:01 AM
Re: small important step...
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Member
Registered: 08/11/03
Posts: 30
Loc: Philadelphia, pa
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to update everyone. i've finally have a diagnosis from my endo doc. i have PCOS. tests are still being taking (ultrasound of ovaries and 24 hour urine test) and i'm now taking glucophage (spelling could be wrong). Well, now that i have a diagnosis and am taking medication, I can start looking upwards out of this hole i am in, and start digging my way out. i recently found out that my aunt and cousin went to an electrologist and were extremely happy with her. now i have to obtain my letters from my doctors and start with the hair removal. any referrals i get will, in time, be put in the referral part of this board. i just want to thank this board and the people on it. if it wasn't for this place, i'd probably still be at square one. thanks all...i'll keep updating as things look forward! [ June 02, 2004, 11:05 AM: Message edited by: babyblue ]
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#10448 - 11/20/04 06:18 PM
Re: small important step...
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Top 10 Contributor
Registered: 06/03/02
Posts: 4886
Loc: Buffalo NY, & Traveling the US...
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Just a little something for those who either don't belive that Insurance pays for this treatment, or that it has to be hard if they do, here is a conversation between two electrologists recently, from another board.
I hope it helps those of you thinking about this insurance payment situation. -------------------------------------------- 11-15-2004
Hope that someone can help me with this!
I have a question that needs to be addressed and I am sure that this situation will become more prevalent in the future.
I have a client with PCOS, who has petitioned her health insurance for coverage of electrolysis treatments. She does have a letter from her OBGYN stating that electrolysis treatments are nessessary for a hirsute problem due to the PCOS. She has been given approval for the treatments.
I have never dealt with an insurance company in this manner and would like to know if someone has and what should I expect. Are there any speacial forms that I should have or get from this client? Do I ask for payment up front and have her get reimbursed herself?
Any help would be greatly appreciated!! Signed, Electrologist A ---------------------------------------------------------------
11-19-2004 I dealt with this several years ago when there were third party payments.
At that time I did get paid and requested the insurance company send the check to the client. If they sent it to me in error I signed it over to them I don't know if they work the same today Signed, Electrologist B ---------------------------------------------------------------- 11-20-2004
Thank You for writing back. I just found out today that the insurance company will be paying me directly. The insurance company gave me an authorization number for her treatments. They have approved my client for treatments for the next to two months then I will reevaluate and submit another request for more appointments. I was very up front about not being able to give a set amount of appointments, when dealing with a case of PCOS. They didn't have a problem with it. I must say that it really wasn't as bad as I thought it would be.
There are a lot of women out there that would come if they were covered by their insurance company. I have a second client who I had go to her OBGYN this week also to request treatment. If there is a diagnosis of PCOS, there should be no question what so ever about electrolysis treatments. I think the insurance companys would rather pay us then someone who is doing laser. Besides, we have 129 years standing behind us, that should stand for something! Signed, Electrologist A
_________________________
Setting a goal is not the main thing. It is deciding how you will go about achieving it and staying with that plan. --- Tom Landry
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#10449 - 01/13/05 06:14 PM
Re: small important step...
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Registered: 01/09/05
Posts: 17
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Thanks - that is an interesting post. I have been told by WAAAAY too many people that insurance will not cover the treatments ... even with a prescription ... I think when i finally find a good doctor I'll see if they'll write me a prescription/letter.
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#10450 - 01/13/05 06:37 PM
Insurance Question
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Registered: 01/09/05
Posts: 17
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Let's say my insurance will pay if I get a letter ... ok ... I saw an endo yrs ago and was never actually diagnosed, but I have had some tests that concluded I had high testosterone ... the glucose tests appeared normal, my weight is fairly normal, as is my menstration ... none of it is perfect of course, but I have a slew of problems ... extreme excess of dark, course hair where women aren't supposed to have it, acne, shaking ... my hands especially shake terribly ... I'm not really thin, but Im not huge ... I eat healthfully for the most part, but I don't get as much exercise as I would like ... one of my eyelids is droopy, think I have asthma or chronic bronchitis/possibly food allergies I need to also get check out for ... anwyay about insurance ... I was never diagnosed with a problem, but since then I have gotten a new job with health benefits. I was on the same type of insurance under my parents' ... will they say it is a preexisting condition and deny me electrolysis or other health coverage now that I am under my own insurance.
Thanks!
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#10451 - 01/14/05 10:41 AM
Re: Insurance Question
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Top 10 Contributor
Registered: 06/03/02
Posts: 4886
Loc: Buffalo NY, & Traveling the US...
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It is always the insurance company's way to tell you anything they can to discourage you and hope you go away.
Of course, since you never were officially diagnosed with anything in particular, how could it be a "preexisting condition"?
In my opinion, what you need is a medical team that works with you to make this happen, and either an insurance company that rolls over, or the fire to make them pay in the end.
Some companies don't sweat you this too much. I wonder if they have just had too many other people sue them and are tired of the court costs.
Some people have said that they got no guff from their company from the start... but those people came to the table with a diagnosis, and a letter written by their doctor.
_________________________
Setting a goal is not the main thing. It is deciding how you will go about achieving it and staying with that plan. --- Tom Landry
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