Last week I refilled one of mother's prescriptions using HEB Pharmacy's telephone system. She was out of refills so I knew it would require her doctor's approval. Yet each time I called using the same system was told it was waiting on the physician's approval. Figured since she had an appointment today perhaps he wanted to see her before refilling it. Nope, he said he faxed his approval to them last week but he gave me a prescription just the same.
I went in person and was told that her doctor's office never faxed an approval so they did not have her medication. Got in line to have the prescription filled and told the technician of my problem with their telephone system and obviously the doctor's office with their electronic fax. Would you believe that her computer showed the opposite of that dumb girl's? Her medication was ready to be picked up. She glared at the girl and told her she needed to pay more attention!
Spent a good part of the morning on the telephone with Medicare Advance Resolution Center as I did not want to be turned away by mother's primary physician's office this afternoon like we were from her Oncologist office last week. Turns out Medicare Secondary Payer Recovery Contractor (MSPRC) did not give me the complete information that was to be included in the Exhaust of Benefits Letter from State Farm to Medicare so I have to go back and have them write another letter. Doesn't anyone take pride in their jobs anymore?
It has been cloudy and windy but not cold and the forecast calls for mild temperatures in the 70's...so I guess I have no more excuses and got to tackle those leaves :-(
Good night. May you all have Terlingua Dreams.
Terlingua Dreams
Governors Landing Campground - Lake Amistad - Del Rio, Texas
Showing posts with label Exhaust of Benefits Letter. Show all posts
Showing posts with label Exhaust of Benefits Letter. Show all posts
Tuesday, January 22, 2013
Thursday, January 17, 2013
Medicare Red Tape
Today was such a beautiful day. Sun was shining and even though it only got up to 63 degrees it felt much warmer. I was in such a good mood I even went to the laundromat! I lucked out there were only two other people there and no screaming tykes :)
The reason I came back so soon from Houston was because mother had a doctor's appointment on Monday (blood work) and today (she would see her doctor). Mother said that they had called on Friday and asked her to come an hour early to fill out paperwork. I thought nothing of it since they usually make you fill out new paperwork each January even though nothing has changed.
When we got there I was asked by one of the girls in the accounting department if I could go into their office because there was a problem with my mother's insurance. She said that Medicare was no longer her primary insurance, that it was showing State Farm to be her primary insurance due to a car accident she had had back in 1999!
I told her she in fact had an accident back then when a drunk driver slammed into the back of a car and that car slammed into my mother's vehicle when she was at a stop light. Thankfully she, my uncle, aunt and cousin were ok.
How that accident that took place thirteen years ago is now showing up in her Medicare record is a mystery. The clerk or whatever she is said that my mother's appointment would have to be cancelled until this was resolved because Medicare would not pay for it. I was incredulous, they were more interested in getting paid than in my mother's health. Did they forget that when they took her in as a patient they made me sign that I would be responsible for paying her bill in case Medicare or her secondary insurance did not pay?
She told me I had to go to the Social Security Office which is what we did Tuesday morning only the coldest morning to date. There I was told that we did not need to have come, that the doctor's office should of provided me with the number to Medicare.
Called Medicare and spoke to three different departments. I lucked out and got a lady named Anissa who knew her job well and told me all the steps I needed to take including getting an Exhaust of Benefits Letter from State Farm. She also told me to tell the accounting department at the Oncologists office that I was working with MSPRC (Medicare Secondary Payer Recovery) and that they would be paid just like they had been paid for the past four years.
Our local State Farm office is owned by the husband of a friend of my mother's and she was very helpful as well. Could not believe that a doctor's office would do that but told us that was not the first time she had heard complaints about them. Unfortunately they are the only game in town as my mother does not want to go see another Oncologist in San Antonio or Houston.
This little error will take about 30 days to be resolved. Thankfully my mother has been in remission for two years otherwise I would have thrown the biggest fit they have ever seen at that doctor's office.
Good night. May you all have Terlingua Dreams.
The reason I came back so soon from Houston was because mother had a doctor's appointment on Monday (blood work) and today (she would see her doctor). Mother said that they had called on Friday and asked her to come an hour early to fill out paperwork. I thought nothing of it since they usually make you fill out new paperwork each January even though nothing has changed.
When we got there I was asked by one of the girls in the accounting department if I could go into their office because there was a problem with my mother's insurance. She said that Medicare was no longer her primary insurance, that it was showing State Farm to be her primary insurance due to a car accident she had had back in 1999!
I told her she in fact had an accident back then when a drunk driver slammed into the back of a car and that car slammed into my mother's vehicle when she was at a stop light. Thankfully she, my uncle, aunt and cousin were ok.
How that accident that took place thirteen years ago is now showing up in her Medicare record is a mystery. The clerk or whatever she is said that my mother's appointment would have to be cancelled until this was resolved because Medicare would not pay for it. I was incredulous, they were more interested in getting paid than in my mother's health. Did they forget that when they took her in as a patient they made me sign that I would be responsible for paying her bill in case Medicare or her secondary insurance did not pay?
She told me I had to go to the Social Security Office which is what we did Tuesday morning only the coldest morning to date. There I was told that we did not need to have come, that the doctor's office should of provided me with the number to Medicare.
Called Medicare and spoke to three different departments. I lucked out and got a lady named Anissa who knew her job well and told me all the steps I needed to take including getting an Exhaust of Benefits Letter from State Farm. She also told me to tell the accounting department at the Oncologists office that I was working with MSPRC (Medicare Secondary Payer Recovery) and that they would be paid just like they had been paid for the past four years.
Our local State Farm office is owned by the husband of a friend of my mother's and she was very helpful as well. Could not believe that a doctor's office would do that but told us that was not the first time she had heard complaints about them. Unfortunately they are the only game in town as my mother does not want to go see another Oncologist in San Antonio or Houston.
This little error will take about 30 days to be resolved. Thankfully my mother has been in remission for two years otherwise I would have thrown the biggest fit they have ever seen at that doctor's office.
Good night. May you all have Terlingua Dreams.
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