BlueandGold
Senior member
- Joined
- Feb 28, 2015
- Messages
- 634
- Reason
- PALS
- Diagnosis
- 04/2015
- Country
- US
- State
- WV
- City
- Sandyville
Got an email from Duke saying that my insurance denied a BiPap for me because I didn't meet Medicare guidelines. Here's what's frustrating:
1. On October 16th Bcbs approved a trilogy for me, however they refused to pay the $1,450 per month and wanted a rent to own deal. DME company refused so no trilogy.
2. Neuro decided to change order from trilogy to BiPap so I could get a "device" to help with breathing.
3. As stated above, Bcbs denied BiPap due to not meeting Medicare guidelines
How in the hell could I be approved for a trilogy yet fail to meet Medicare guidelines for a BiPap? Furthermore, why are Medicare guidelines being used when my primary insurance is commercial Bcbs? I'd be willing to bet that the next denial will be placement of feeding tube, which I have a surgical consult for next week. I'm convinced they do no want Pals to be able to extend their lives. With all we have to deal with....what a punch in the gut.
Vince
1. On October 16th Bcbs approved a trilogy for me, however they refused to pay the $1,450 per month and wanted a rent to own deal. DME company refused so no trilogy.
2. Neuro decided to change order from trilogy to BiPap so I could get a "device" to help with breathing.
3. As stated above, Bcbs denied BiPap due to not meeting Medicare guidelines
How in the hell could I be approved for a trilogy yet fail to meet Medicare guidelines for a BiPap? Furthermore, why are Medicare guidelines being used when my primary insurance is commercial Bcbs? I'd be willing to bet that the next denial will be placement of feeding tube, which I have a surgical consult for next week. I'm convinced they do no want Pals to be able to extend their lives. With all we have to deal with....what a punch in the gut.
Vince