FrankTalk.org

How did you get UMMC to accept your UC insurance. They are asking UC for a preauthorization. UC says Missouri law says they don't have to pre-authorize so will not. Attached is a copy of the letter where I went through an appeal with the same issue in 2015. 2:47 p.m. on a Friday, I will be in Baltimore on Monday and everyone decides to work on this. I thought it was taken care of 3 weeks ago. Top that off they have been giving UC the wrong code. Someone told them I have never had an implant before.

alibaba wrote:How did you get UMMC to accept your UC insurance. They are asking UC for a preauthorization. UC says Missouri law says they don't have to pre-authorize so will not. Attached is a copy of the letter where I went through an appeal with the same issue in 2015. 2:47 p.m. on a Friday, I will be in Baltimore on Monday and everyone decides to work on this. I thought it was taken care of 3 weeks ago. Top that off they have been giving UC the wrong code. Someone told them I have never had an implant before.

Alibaba:

I had no problem whatsoever w/ insurance coverage. I had Anthem/Blue Cross at the time of the procedure (switching over to Medicare/Medicare Part B Supplement on 3/1/17). All I had to do was document the procedure as a medical necessity. I subsequently received a letter which stated that the procedure would be covered within a one-year window. Everything was covered except a $35.00 co-pay for my pre-op meeting w/ Dr. Kramer the day before the procedure plus my pre-op tests w/ my internist at Barnes (another $35.00 co-pay). Dr. Kramer's assistant Connie was extremely helpful throughout the entire process. Bottom line: everything went smoothly & there was never any question from either Dr. Kramer's office, UMMC or Anthem/Blue Cross that I was completely covered. I was very fortunate.

Thanks for the reply. Must be a memory lapse. Someone here messaged me that UMMC was taking United Healthcare again and covered their surgery and let me know so I could see Dr. Kramer. I was thinking it was you as I know you have shared some helpful information to me. Thank you for the help.

Wow! $70 for an implant. Wonder you don't just trade them in for a new model once in a while like cars at that price. Glad it went smooth. I think if anything ever goes smooth I will fall over dead of shock. Barnes ( Wash U) used to do my pre-ops w/o a hitch but I got tired of the trips to St. Louis. Even if insurance covered them, there was the $400 fee to get out of Costco with a cart load every time.

Correcting my mistake. It was williamb who put me on to UHC being accepted at UMMC again. Thank you again. Show time 6:15 a.m. 03/01/2017 Don't pull a Kramer ( Seinfeld). I don't want any spilled candy in my scrotum with the pump.