[crash] better late than never

[topaz]

.... or something:

Dear Member:

After careful review by the Clinical Coordination Department of Blue Cross Blue Shield of Massachusetts, I am pleased to inform you that the request for hospital services made on your behalf has been approved.

Place of Service: Inpatient Acute Care Hospital
Type of Service: Medical Care

An "acute care facility" is what we were fighting to get keyne sent to after MGH, since her surgeon had stressed the importance of her getting "active, aggressive physical therapy" as soon as possible.  Because they would not approve acute care, on June 14 we accepted their offer of a "skilled nursing facility" instead.

The letter is dated June 16.  We just received it today.  Imagine -- that their costs have risen so that they have to use fourth-class mail for everything!  It must be horrible for them.  Just think, soon they may not even be able to afford enough staff to reject every initial claim that gets filed.

Comments

[agaran.livejournal.com]

That was a pretty critical 10 day period during which her therapy would have been extremely valuable. What an amazing shoot-yourself-in-the-foot move that was on their part, because it could cost them a lot more now in the long run. Morons.

[ckd]

The letter's dated the 16th...what's the postmark/meter date?

[qwrrty.livejournal.com]

"First Class Mail
Presort
U.S. Postage
PAID
Boston, MA"

No postmark date at all -- because it's prepaid? So, true, they didn't send it fourth class mail (though they seem to have treated it as such).

[ckd]

Yay. Presort. IOW, they sent it in a batch along with other stuff...which they probably only do when they've saved up enough letters to get a presort batch discount. May as well have been fourth class.

[aroraborealis.livejournal.com]

Just think, soon they may not even be able to afford enough staff to reject every initial claim that gets filed.

*laugh* I love you, qwrrty!

[harimad.livejournal.com]

Along these lines...

We went in for amnio and light genetic testing. Heath Care Company covered amnio but initially rejected genetic testing on the grounds that they don't cover infertility services. For someone who went in for amnio. To the best of my knowledge, one can get amnio only when one has amniotic fluid and one can only have amniotic fluid when one is pregnant.

When writing the "what the hell are you smoking" appeal letter, it proved impossible not to be snarky. If the letter had a subject line, it would have been "Infertility treatment is considered medically inappropriate for patients already pregnant."

[creidylad.livejournal.com]

In case you need to sue their butts later, you should write them a letter of complaint about the lateness of their reply now, just for extra documentation.

[agaran.livejournal.com]

What he said.

[jacflash.livejournal.com]

Thirded.

[actjack.livejournal.com]

THE INSURANCE CRETINS STILL LIVE!