circular wrote:Thanks Nords! That is very encouraging that we might get a favorable outcome on appeal. I posted elsewhere how my LO keeps passing the MMSE. Thankfully we got a second, followup neuropsych in time for the appeal paperwork and it says Alzheimer's. I told the neuropsych doc when he interviewed me that the MMSE is the bane of my existence, and he laughed as if to say, 'ya, what a piece of junk that is', although I don't mean to be quoted as saying an expert said those words. It was just my takeaway.
circular wrote:My LO was the same way Julie. Out to impress and what a tangled web she wove! I got three letters from various of her specialists for the appeal, since the insurance company believed her over the letter from her internist submitted with the original claim :evil:
I just saw this thread about the study that is paying for PET scans for Medicare beneficiaries. My LO did this last winter. That has also been submitted on appeal because it indicates the scan is consistent with Alzheimer's. It might be helpful for anyone else going through this to ask the neurologist to help the patient participate in the PET scan trial for additional documentation.
Juliegee wrote:... but practically popped up and offered to do one armed pushups for the attractive young nurse to show her how healthy he was...
circular wrote:By the way, I've been reading Bob DeMarco's articles as they're emailed to me ever since you mentioned that site. They great easy bites to fit into busy days.
circular wrote:Thanks for mentioning the commissioner Nords. I hadn't thought of that. Hopefully it won't come to it.
circular wrote:... while ripping out my hair trying to track all the medical payments through various doctors, Medicare, Medicare supplement, my mother paying up front sometimes and not others, what gets reimbursed and what doesn't, and which actually got reimbursed that should have been, and when if ever can a doctor require up front payment and ... I hate this. Maybe just pay the bills I'm told are due and don't question, but mom used to get a lot of reimbursement checks from Medicare and Med Supp and this year has hardly gotten any at all. Ugh. Sorry for another vent.
circular wrote:Thanks for being my misery loves company company Bro! Crazy how endless the little things are. What I don't understand about your situation is that Medicare should automatically be passing along statements of what it's not paying to the Medicare supplement company. Is your father's insurance from a former employer? I think that can change the mechanisms. Gee you may have it worse in this department worse than me. Things normally go smoothly with my mother's medical paperwork, it was just the case of the disappearing reimbursement checks.
circular wrote:Is his plan a traditional 'Medicare supplement' plan with a letter designation based on what it covers of approved Medicare expenses? Or does he have a retiree plan through an employer with its own features?
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