I contacted my lawyer to see if I'd get in trouble for impersonating a deaf person. He hung up when I said I wanted a hearing. Actually, TTY merely does Voice-to-Text conversion, as far as I can make out. I think all I would get is gobbledygook.
So you accepted my challenge, did you? Well, did your attorney so that it was illegal? John B. you are making excuses. Communication is communicating any way you can get someone to understand what you want and for you to be able to understand them as well. If you can not understand the person on the other end you need help and they need someone that can help you to understand what is being said to you. I'll save what I think about your attorney. What is the worst that could happen for impersonating a deaf person and how are they going to know that you are deaf? As long as you can type well and not tell a story while your doing it, hmmm? I know you have a good heart and right now I'm being the devil's advocate but in a good way. No one is going to get harmed. On the other hand, your number could be traced and they'll come and get you.
Yup. I have asked to speak with someone else before, and tried to do it nicely. I may have to do that again. For now, I need to do online research to get a feel for the history of this thing. I was told I was paying for it without insurance being involved, but the email I got thee other say said it had been submitted to insurance every time. Again, I cannot speak directly with a human being at this pharmacy. When I'm ready, I'm gonna try to set up a phone call. If that doesn't work, I'll go to the owner (who, sadly, I believe is the problem.)
Uh oh, it's been submitted to your insurance?! You need to do some research on that too. Find out if it's been denied and why. OMGoodness! You're saying you pay and it was submitted to your insurance? If you paid that can only mean it isn't covered. Did you get Explanation of Benefits for any? Hold off on the TTY call. You need to get your ducks in a row first. You need to know if your script is covered and if the claims 'have been submitted' and if denied 'why?' Was it a diagnosis or just not covered or something else? If it's a diagnosis then what code is acceptable to get it paid, at least in part. Why am I so gung ho about this? Because it's mula.
The billing code changed so my insurance stopped reimbursing me for it. I believe they kept running it though my insurance to get the cost documented so it contributes to my out-of-pocket maximum. This is another aspect of Medicare Script Plans I need to research, along with the Explanation of Benefits I need to dig up online.
SMH. The billing code is usually changed by the physician unless the coding staff coded incorrectly. Those claims can be resubmitted with the correct code (the one that was getting the claim paid). That out of pocket money is going into your doctor's pocket. Whether he knows it or not. I would definitely ask why it's not getting paid anymore and you have been paying out of pocket for it. It's being submitted because it got paid before and as long as it isn't questioned you will still be paying out of pocket. It's called patient's bill of rights to question. Doctor's don't handle billing/insurance his staff or whoever does the billing so making him aware is just getting the wheels turning but he can check his diagnosis.
I believe the code is driven by Medicare, but I might be wrong. Thanks for the ideas...I'm putting together a To Do list.
But the physician/doctor should be aware of it also. FYI - I was doing medical billing and insurance before I retired.
@Von Jones is correct in saying the doctors have no control or (sometimes) even input into billing. They generally accept what is coming as long as they are solvent. Medicare and Medicaid have CPT codes and ICD codes that they accept, and those often vary by state, so what is accepted in Ohio may not be accepted in Virginia, at least that is how things worked when I had to deal with such things. Many times the billing is coded off-site, sometimes in a different area of the country. What may have happened is that your script was coded as one thing for your previous drugs and it was on the "acceptable" list, but someone may have changed the acceptable list and the previous code may not work but the drug may still be covered under a new or different code. I am thinking that the old codes were submitted and rejected, but no research was done since you are willing to pay out-of-pocket.
I was glad to pay out of pocket. My co-pay was $68. Out of pocket was only $39. But I don't know if that lower amount was because I crossed some "Total Out Of Pocket" threshold that happened to coincide with the change in billing code. The woman at the location where I picked up my script said she had never seen Medicare cover a compounded script. This may be a Virginia thing.
I'll let you know how it works out. I got research to do first (script insurance and Medicare rules.)
The World Economic Forum is nuts but apparently have power or why would they keep meeting. None of these people look like they have skipped any meals but we should, or eat bugs. On the positive side, Texas is standing up to the Federal gov't and protecting out border against Biden's orders. There are rumors that other states may come to stand with them. The President's job is to see that our laws are enforced and the Federal gov't is supposed to protect us from foreign invaders.
I saw a headline that Texas was ignoring a cease and desist and Florida was coming to stand with them. I didn't read the article, but sounds hopeful.