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Re: New to the Group

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  • lajarvis78
    As I stated earlier I am new to this group, so I don t what has been discussed regarding the letter...my main suggestion is to use concrete examples of issues
    Message 1 of 6 , Aug 11, 2005
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      As I stated earlier I am new to this group, so I don't what has been
      discussed regarding the letter...my main suggestion is to use
      concrete examples of issues we have had. Here are some of mine:

      - PC gave me wrong forms when filing, so some claims were rejected
      and needed to be resent. Work comp told me that they have this
      problem all the time and they said that there is no communication
      between the two offices.

      - Time lap between PC medically separating volunteers and the 3
      months when work comp kicks in (if it does at all). That we are
      sick, PC kicks us out and we are forced to pay all medical bills out
      of our own pocket. I'm still trying to get reimbursed for all
      medical bills during that time.

      - The fact that case workers are not allowed to talk to the billing
      department, but yet the billing department constantly sends you back
      to your case worker to change things. Again, no communication
      between departments and they put us in the middle to try and figure
      out what each of them need so we can get our money!

      - The fact that they say that there are scheduling fees for every
      procedure and medicine, but yet they do not pay the same amount if
      you find a service or meds for cheaper (i.e. I was put on a very
      expensive antibiotic, CVS charged $120 for 10 days, work comp gave
      me $111 in reimbursement. Had to get a refill and this time went to
      Target who charged $80 for the pills, yet work comp only paid around
      $73 for the med).

      - There is no set procedure for filing an appeal. Yes, you can
      resubmit with a letter, but they never clearly state why it has been
      rejected and what you can do so that you can be paid.

      Those are the examples I could think of off the top of my head that
      I have dealt with. I'm sure I could come with many more, given more
      time. I will gladly have my name attached to this letter. It is
      nice to know that I am not alone in my frustrations, though I'm very
      sorry that all you are going through this too...it's just no fun!

      My info for the letter: I am from Sherman Oaks, CA 91403

      Take care all!
      --Lauralee
      RPCV EC70: Dominica
    • Kevin
      Lauralee, Thanks for your comments. I ve been grappling with the issue of examples since I wrote the first draft of the letter. I purposely left them out of
      Message 2 of 6 , Aug 17, 2005
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        Lauralee,

        Thanks for your comments.

        I've been grappling with the issue of examples since I wrote the
        first draft of the letter. I purposely left them out of that draft
        because I didn't want all of them to come from my personal
        experience. I plan to include some examples in the next draft,
        primarily drawing them from critiques that I've received from group
        members. However, I don't feel that I can include all of the
        examples that I've received, so I'll try to include ones that seem
        most universal.

        If you and others feel strongly that more of your experiences,
        issues, complaints, etc. need to be included, what do you think of
        allowing an addendum for each signatory to briefly address his or
        her story? Preparing an addendum would be optional, of course, and
        each signatory could decide whether to opt in or opt out.

        I apologize for not getting the second draft written in a timely
        fashion. I had anticipated it being done by know, but my schedule
        has not been cooperating. My new goal for completion is early in
        September. (I'll be out of town for about 10 days starting later
        this week.)

        Kevin

        P.S. Lauralee, and everyone: Your comments and suggestions about
        examples (and anything else) are welcome, as always. Although I've
        taken the lead with the letter, it is a group effort. Thanks!


        --- In owcp@yahoogroups.com, "lajarvis78" <RPCVLAJarvis@a...> wrote:
        > As I stated earlier I am new to this group, so I don't what has
        been
        > discussed regarding the letter...my main suggestion is to use
        > concrete examples of issues we have had. Here are some of mine:
        >
        > - PC gave me wrong forms when filing, so some claims were rejected
        > and needed to be resent. Work comp told me that they have this
        > problem all the time and they said that there is no communication
        > between the two offices.
        >
        > - Time lap between PC medically separating volunteers and the 3
        > months when work comp kicks in (if it does at all). That we are
        > sick, PC kicks us out and we are forced to pay all medical bills
        out
        > of our own pocket. I'm still trying to get reimbursed for all
        > medical bills during that time.
        >
        > - The fact that case workers are not allowed to talk to the
        billing
        > department, but yet the billing department constantly sends you
        back
        > to your case worker to change things. Again, no communication
        > between departments and they put us in the middle to try and
        figure
        > out what each of them need so we can get our money!
        >
        > - The fact that they say that there are scheduling fees for every
        > procedure and medicine, but yet they do not pay the same amount if
        > you find a service or meds for cheaper (i.e. I was put on a very
        > expensive antibiotic, CVS charged $120 for 10 days, work comp gave
        > me $111 in reimbursement. Had to get a refill and this time went
        to
        > Target who charged $80 for the pills, yet work comp only paid
        around
        > $73 for the med).
        >
        > - There is no set procedure for filing an appeal. Yes, you can
        > resubmit with a letter, but they never clearly state why it has
        been
        > rejected and what you can do so that you can be paid.
        >
        > Those are the examples I could think of off the top of my head
        that
        > I have dealt with. I'm sure I could come with many more, given
        more
        > time. I will gladly have my name attached to this letter. It is
        > nice to know that I am not alone in my frustrations, though I'm
        very
        > sorry that all you are going through this too...it's just no fun!
        >
        > My info for the letter: I am from Sherman Oaks, CA 91403
        >
        > Take care all!
        > --Lauralee
        > RPCV EC70: Dominica
      • Donald Weaks
        Kevin, I have been reading your correspondence but I have not added any examples because I have sent OMS a letter asking (demanding) a critical review of my
        Message 3 of 6 , Aug 17, 2005
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          Kevin, I have been reading your correspondence but I have not added any examples because I have sent OMS a letter asking (demanding) a critical review of my case before 1 September. If nothing happens by then, I will have examples to add to your letter. I also plan to contact the OIG after 1 September. Good luck and have a safe trip. Don 

          Kevin <rpcv@...> wrote:
          Lauralee,

          Thanks for your comments. 

          I've been grappling with the issue of examples since I wrote the
          first draft of the letter.  I purposely left them out of that draft
          because I didn't want all of them to come from my personal
          experience.  I plan to include some examples in the next draft,
          primarily drawing them from critiques that I've received from group
          members.  However, I don't feel that I can include all of the
          examples that I've received, so I'll try to include ones that seem
          most universal.

          If you and others feel strongly that more of your experiences,
          issues, complaints, etc. need to be included, what do you think of
          allowing an addendum for each signatory to briefly address his or
          her story?  Preparing an addendum would be optional, of course, and
          each signatory could decide whether to opt in or opt out.

          I apologize for not getting the second draft written in a timely
          fashion.  I had anticipated it being done by know, but my schedule
          has not been cooperating.  My new goal for completion is early in
          September.  (I'll be out of town for about 10 days starting later
          this week.)

          Kevin

          P.S.  Lauralee, and everyone:  Your comments and suggestions about
          examples (and anything else) are welcome, as always.  Although I've
          taken the lead with the letter, it is a group effort.  Thanks!


          --- In owcp@yahoogroups.com, "lajarvis78" <RPCVLAJarvis@a...> wrote:
          > As I stated earlier I am new to this group, so I don't what has
          been
          > discussed regarding the letter...my main suggestion is to use
          > concrete examples of issues we have had.  Here are some of mine:
          >
          > - PC gave me wrong forms when filing, so some claims were rejected
          > and needed to be resent.  Work comp told me that they have this
          > problem all the time and they said that there is no communication
          > between the two offices.
          >
          > - Time lap between PC medically separating volunteers and the 3
          > months when work comp kicks in (if it does at all).  That we are
          > sick, PC kicks us out and we are forced to pay all medical bills
          out
          > of our own pocket.  I'm still trying to get reimbursed for all
          > medical bills during that time.
          >
          > - The fact that case workers are not allowed to talk to the
          billing
          > department, but yet the billing department constantly sends you
          back
          > to your case worker to change things.  Again, no communication
          > between departments and they put us in the middle to try and
          figure
          > out what each of them need so we can get our money!
          >
          > - The fact that they say that there are scheduling fees for every
          > procedure and medicine, but yet they do not pay the same amount if
          > you find a service or meds for cheaper (i.e. I was put on a very
          > expensive antibiotic, CVS charged $120 for 10 days, work comp gave
          > me $111 in reimbursement.  Had to get a refill and this time went
          to
          > Target who charged $80 for the pills, yet work comp only paid
          around
          > $73 for the med).
          >
          > - There is no set procedure for filing an appeal.  Yes, you can
          > resubmit with a letter, but they never clearly state why it has
          been
          > rejected and what you can do so that you can be paid.
          >
          > Those are the examples I could think of off the top of my head
          that
          > I have dealt with.  I'm sure I could come with many more, given
          more
          > time.  I will gladly have my name attached to this letter.  It is
          > nice to know that I am not alone in my frustrations, though I'm
          very
          > sorry that all you are going through this too...it's just no fun!
          >
          > My info for the letter: I am from Sherman Oaks, CA  91403
          >
          > Take care all!
          > --Lauralee
          > RPCV EC70: Dominica





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        • Janice Williams
          Jan Williams ... This sounds good to me , too. Jan Williams
          Message 4 of 6 , Aug 21, 2005
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            Jan Williams

            > Lauralee,
            >
            > Thanks for your comments.
            >
            > I've been grappling with the issue of examples since I wrote the
            > first draft of the letter. I purposely left them out of that draft
            > because I didn't want all of them to come from my personal
            > experience. I plan to include some examples in the next draft,
            > primarily drawing them from critiques that I've received from group
            > members. However, I don't feel that I can include all of the
            > examples that I've received, so I'll try to include ones that seem
            > most universal.
            >
            > If you and others feel strongly that more of your experiences,
            > issues, complaints, etc. need to be included, what do you think of
            > allowing an addendum for each signatory to briefly address his or
            > her story? Preparing an addendum would be optional, of course, and
            > each signatory could decide whether to opt in or opt out.
            >
            > I apologize for not getting the second draft written in a timely
            > fashion. I had anticipated it being done by know, but my schedule
            > has not been cooperating. My new goal for completion is early in
            > September. (I'll be out of town for about 10 days starting later
            > this week.)
            >
            > Kevin
            >
            > P.S. Lauralee, and everyone: Your comments and suggestions about
            > examples (and anything else) are welcome, as always. Although I've
            > taken the lead with the letter, it is a group effort. Thanks!
            >
            >
            > --- In owcp@yahoogroups.com, "lajarvis78" <RPCVLAJarvis@a...> wrote:
            >> As I stated earlier I am new to this group, so I don't what has
            > been
            >> discussed regarding the letter...my main suggestion is to use
            >> concrete examples of issues we have had. Here are some of mine:
            >>
            >> - PC gave me wrong forms when filing, so some claims were rejected
            >> and needed to be resent. Work comp told me that they have this
            >> problem all the time and they said that there is no communication
            >> between the two offices.
            >>
            >> - Time lap between PC medically separating volunteers and the 3
            >> months when work comp kicks in (if it does at all). That we are
            >> sick, PC kicks us out and we are forced to pay all medical bills
            > out
            >> of our own pocket. I'm still trying to get reimbursed for all
            >> medical bills during that time.
            >>
            >> - The fact that case workers are not allowed to talk to the
            > billing
            >> department, but yet the billing department constantly sends you
            > back
            >> to your case worker to change things. Again, no communication
            >> between departments and they put us in the middle to try and
            > figure
            >> out what each of them need so we can get our money!
            >>
            >> - The fact that they say that there are scheduling fees for every
            >> procedure and medicine, but yet they do not pay the same amount if
            >> you find a service or meds for cheaper (i.e. I was put on a very
            >> expensive antibiotic, CVS charged $120 for 10 days, work comp gave
            >> me $111 in reimbursement. Had to get a refill and this time went
            > to
            >> Target who charged $80 for the pills, yet work comp only paid
            > around
            >> $73 for the med).
            >>
            >> - There is no set procedure for filing an appeal. Yes, you can
            >> resubmit with a letter, but they never clearly state why it has
            > been
            >> rejected and what you can do so that you can be paid.
            >>
            >> Those are the examples I could think of off the top of my head
            > that
            >> I have dealt with. I'm sure I could come with many more, given
            > more
            >> time. I will gladly have my name attached to this letter. It is
            >> nice to know that I am not alone in my frustrations, though I'm
            > very
            >> sorry that all you are going through this too...it's just no fun!
            >>
            >> My info for the letter: I am from Sherman Oaks, CA 91403
            >>
            >> Take care all!
            >> --Lauralee
            >> RPCV EC70: Dominica
            >
            >
            >
            >
            >
            >
            >
            > Yahoo! Groups Links
            >
            >
            >
            >
            >
            >
            This sounds good to me , too. Jan Williams
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