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Sue:practitioner issues

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  • FourDirect@aol.com
    In a message dated 8/5/2007 11:30:07 P.M. Eastern Standard Time, sallie_ali_sue@yahoo.com writes: I get the feeling that I m the only one in this forum whose
    Message 1 of 4 , Aug 5, 2007
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      In a message dated 8/5/2007 11:30:07 P.M. Eastern Standard Time, sallie_ali_sue@... writes:
      I get the feeling that I'm the only one in this forum
      whose gripe is general.
      Sue,
       
      Oh no, I have very general (as well as specific) gripes! There are no longer any doctors in NY who will bill ACS or OWCP because they are sick of never getting paid and having to play repetitive games of submitting and resubmitting bills. I finally went on Medicare (SS disability) and let doctors bill them just to get anything covered. It's wrong for Medicare to have to pay for what OWCP should pay but I have to get out of pain and survive. I still struggle with some that get submitted to OWCP.
       
      With others, I pay up front and then I fill out all the HCFA 1500 forms and have my health care providers sign and I submit them on behalf of them. They generally get approved on the 11th or the 13th try. There seems to be a pattern of rejection, which I wish I could actually prove. If and when the health care provider is reimbursed (sometimes years later) I have to follow up with them to have them pay me. It wreaks havoc with their accounting and forces me to borrow money to obtain medical care. It is pretty much right out of the film "Sicko." And I wish I had known that Michael Moore was doing the film as this story would have been so perfect.
       
      I'm poor, I'm sick, I'm in pain all the time and I'm sick of the whole mess. I just see no way to rectify this issue of doctors being unwilling to bill OWCP/ACS. They have a choice though and they have been forced to decide whether to treat those they can or to spend their lives dealing with this mess of a bureaucracy. We, unfortunately, have no choice. It is all quite sad as we pay such a huge price.
       
      While living in AZ I had to drive hundreds of miles to get some medical care and I had to up-front the money and do my own billing with all the rest. It has gone on like this for years. I understand, is all I can say.
       
      Nancy Tongue




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    • Felicia
      The crazy part about this is that I haven t had too much trouble finding a doctor who will bill OWCP. Could it be that Oregon, not being that populous, just
      Message 2 of 4 , Aug 6, 2007
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        The crazy part about this is that I haven't had too much
        trouble finding a doctor who will bill OWCP. Could it be
        that Oregon, not being that populous, just hasn't stressed
        doctors out that much yet? Weird! The problems I have
        usually relate to the diagnosis codes that the billing
        people submit. Apparently, the trick is that if you
        hassle your claims examiner enough, then he or she will go
        in and change the numbers by hand to whatever will get it
        through ACS. I really wondered after the last round of
        this (which they finally paid!!) if they are using a
        different system of
        diagnosis codes than the lab that submitted the claim. It
        was so weird. There is definitely a difference between
        claims examiners, though. I usually send a letter every
        couple months listing all the currently unresolved
        problems I'm having with OWCP. Sometimes, I get a letter
        back and sometimes I get nothing. Once, the best claims
        examiner ever resolved every single item on the list! I
        only had her for about a month, though. I guess that is
        one of my big complaints. What is wrong with me is very
        confusing. It is so confusing (and due to the lack of any
        help from the Peace Corps, it is all based on bits and
        pieces of data from a bunch of sources) that it is quite
        difficult for someone who is new to my case to quickly get
        a handle on what my situation is. However, my claims
        examiner changes really frequently (I'm assuming that they
        quit). At this point, I've sort of come up with a system
        for dealing with this mess, but it would be tons easier if
        I didn't have to explain to each new claims examiner why
        I'm sick. -- Felicia

        >
        > In a message dated 8/5/2007 11:30:07 P.M. Eastern Standard
        > Time,
        > sallie_ali_sue@... writes:
        >
        > I get the feeling that I'm the only one in this forum
        > whose gripe is general.
        >
        >
        >
        > Sue,
        >
        > Oh no, I have very general (as well as specific) gripes!
        > There are no longer
        > any doctors in NY who will bill ACS or OWCP because they
        > are sick of never
        > getting paid and having to play repetitive games of
        > submitting and
        > resubmitting bills. I finally went on Medicare (SS
        > disability) and let doctors bill them
        > just to get anything covered. It's wrong for Medicare to
        > have to pay for
        > what OWCP should pay but I have to get out of pain and
        > survive. I still struggle
        > with some that get submitted to OWCP.
        >
        > With others, I pay up front and then I fill out all the
        > HCFA 1500 forms and
        > have my health care providers sign and I submit them on
        > behalf of them. They
        > generally get approved on the 11th or the 13th try. There
        > seems to be a
        > pattern of rejection, which I wish I could actually
        > prove. If and when the health
        > care provider is reimbursed (sometimes years later) I have
        > to follow up with
        > them to have them pay me. It wreaks havoc with their
        > accounting and forces me
        > to borrow money to obtain medical care. It is pretty much
        > right out of the
        > film "Sicko." And I wish I had known that Michael Moore
        > was doing the film as
        > this story would have been so perfect.
        >
        > I'm poor, I'm sick, I'm in pain all the time and I'm sick
        > of the whole mess.
        > I just see no way to rectify this issue of doctors being
        > unwilling to bill
        > OWCP/ACS. They have a choice though and they have been
        > forced to decide whether
        > to treat those they can or to spend their lives dealing
        > with this mess of a
        > bureaucracy. We, unfortunately, have no choice. It is all
        > quite sad as we pay
        > such a huge price.
        >
        > While living in AZ I had to drive hundreds of miles to get
        > some medical care
        > and I had to up-front the money and do my own billing with
        > all the rest. It
        > has gone on like this for years. I understand, is all I
        > can say.
        >
        > Nancy Tongue
        >
        >
        >
        > ************************************** Get a sneak peek of
        > the all-new AOL at
        > http://discover.aol.com/memed/aolcom30tour
        >
      • Christine Link
        Wow, I feel like I just read about my problems. And, to boot, my doctor s billing office has taken the difference between what ACS/OWCP has paid and what they
        Message 3 of 4 , Aug 10, 2007
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          Wow, I feel like I just read about my problems. And, to boot, my doctor's billing office has taken the difference between what ACS/OWCP has paid and what they normally charge from me (I had to do the pay up front thing, too, and then submit later, but then the doctor's office finally submitted for me as I had a wonderful doctor who thought the whole thing was crazy, but then sadly passed away).

          Anyway, Nancy and Felicia, it's at least nice to have some other folks in the same boat!

          Christine

          On Monday, August 06, 2007, at 11:55AM, "Felicia" <felicia@...> wrote:
          >The crazy part about this is that I haven't had too much
          >trouble finding a doctor who will bill OWCP. Could it be
          >that Oregon, not being that populous, just hasn't stressed
          >doctors out that much yet? Weird! The problems I have
          >usually relate to the diagnosis codes that the billing
          >people submit. Apparently, the trick is that if you
          >hassle your claims examiner enough, then he or she will go
          >in and change the numbers by hand to whatever will get it
          >through ACS. I really wondered after the last round of
          >this (which they finally paid!!) if they are using a
          >different system of
          >diagnosis codes than the lab that submitted the claim. It
          >was so weird. There is definitely a difference between
          >claims examiners, though. I usually send a letter every
          >couple months listing all the currently unresolved
          >problems I'm having with OWCP. Sometimes, I get a letter
          >back and sometimes I get nothing. Once, the best claims
          >examiner ever resolved every single item on the list! I
          >only had her for about a month, though. I guess that is
          >one of my big complaints. What is wrong with me is very
          >confusing. It is so confusing (and due to the lack of any
          >help from the Peace Corps, it is all based on bits and
          >pieces of data from a bunch of sources) that it is quite
          >difficult for someone who is new to my case to quickly get
          >a handle on what my situation is. However, my claims
          >examiner changes really frequently (I'm assuming that they
          >quit). At this point, I've sort of come up with a system
          >for dealing with this mess, but it would be tons easier if
          >I didn't have to explain to each new claims examiner why
          >I'm sick. -- Felicia
          >
          >>
          >> In a message dated 8/5/2007 11:30:07 P.M. Eastern Standard
          >> Time,
          >> sallie_ali_sue@... writes:
          >>
          >> I get the feeling that I'm the only one in this forum
          >> whose gripe is general.
          >>
          >>
          >>
          >> Sue,
          >>
          >> Oh no, I have very general (as well as specific) gripes!
          >> There are no longer
          >> any doctors in NY who will bill ACS or OWCP because they
          >> are sick of never
          >> getting paid and having to play repetitive games of
          >> submitting and
          >> resubmitting bills. I finally went on Medicare (SS
          >> disability) and let doctors bill them
          >> just to get anything covered. It's wrong for Medicare to
          >> have to pay for
          >> what OWCP should pay but I have to get out of pain and
          >> survive. I still struggle
          >> with some that get submitted to OWCP.
          >>
          >> With others, I pay up front and then I fill out all the
          >> HCFA 1500 forms and
          >> have my health care providers sign and I submit them on
          >> behalf of them. They
          >> generally get approved on the 11th or the 13th try. There
          >> seems to be a
          >> pattern of rejection, which I wish I could actually
          >> prove. If and when the health
          >> care provider is reimbursed (sometimes years later) I have
          >> to follow up with
          >> them to have them pay me. It wreaks havoc with their
          >> accounting and forces me
          >> to borrow money to obtain medical care. It is pretty much
          >> right out of the
          >> film "Sicko." And I wish I had known that Michael Moore
          >> was doing the film as
          >> this story would have been so perfect.
          >>
          >> I'm poor, I'm sick, I'm in pain all the time and I'm sick
          >> of the whole mess.
          >> I just see no way to rectify this issue of doctors being
          >> unwilling to bill
          >> OWCP/ACS. They have a choice though and they have been
          >> forced to decide whether
          >> to treat those they can or to spend their lives dealing
          >> with this mess of a
          >> bureaucracy. We, unfortunately, have no choice. It is all
          >> quite sad as we pay
          >> such a huge price.
          >>
          >> While living in AZ I had to drive hundreds of miles to get
          >> some medical care
          >> and I had to up-front the money and do my own billing with
          >> all the rest. It
          >> has gone on like this for years. I understand, is all I
          >> can say.
          >>
          >> Nancy Tongue
          >>
          >>
          >>
          >> ************************************** Get a sneak peek of
          >> the all-new AOL at
          >> http://discover.aol.com/memed/aolcom30tour
          >>
          >
          >
          >
        • FourDirect@aol.com
          In a message dated 8/10/2007 1:58:11 P.M. Eastern Standard Time, clberna@mac.com writes: Anyway, Nancy and Felicia, it s at least nice to have some other folks
          Message 4 of 4 , Aug 10, 2007
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            In a message dated 8/10/2007 1:58:11 P.M. Eastern Standard Time, clberna@... writes:
            Anyway, Nancy and Felicia, it's at least nice to have some other folks in the same boat!

            Christine
            Christine,
             
            I hate to say "welcome aboard!" but you are definitely not alone and we are determined not to sink!
            Nancy T.




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