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UPS Union Issues
Teamcare - something to watch for on procedure claims
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<blockquote data-quote="BrownBrokeDown" data-source="post: 1433399" data-attributes="member: 46824"><p>Another <img src="/community/styles/default/xenforo/smilies/group1/censored2.gif" class="smilie" loading="lazy" alt=":censored2:" title="Censored2 :censored2:" data-shortname=":censored2:" />ing Update:</p><p> </p><p>So Doctor's office called again, had me call again. Wow...Once again today the person i spoke with at Teamcare gave me an intirely different response. What this one said is Ultrasounds and X-rays even during procedures are only covered 80% as they are non-invasive whereas something like a scope (which is invasive) utilized during a procedure is covered 100%. She told me to have the doctors office go ahead and submit the appeal but that it would most likely be denied. Also, ultrasounds and x-rays are 80% regardless of where it is done as US imaging is for CTscans, mri's and petscans only. I then spent 15 mins explaining to her how I was sick and tired of getting different answers everytime i called. I also told her about the instance where i called spoke with one lady that said the file stated it was medically unnecessary. She then transfered me to someone i had spoke to before that said she had no idea where the other lady had seen that as it didn't say it anywhere. The one i spoke to today seemed amazed at everything i told her. She said that she almost would have understood if someone didn't give enough information, but was appalled at the idea that i had received so much "misiniformation".</p><p> </p><p> </p><p>On another note. a month ago, my son sustained a grade 2 concussion. Wife took to hospital because he was having severe concussion symptons. At the hospital he kept repeating the same 2 questions over and over, etc. I owe $500 because it's not listed as life-threatening. Funny story though (that is sarcasm), last week someone I work with at my other job, had his daughter get dropped during cheerleader practice. Took her to an urgent care facility. They sent him straight to the emergency room. She had a "minor" concussion without a lot of the issues my son had. </p><p> </p><p>This <img src="/community/styles/default/xenforo/smilies/group1/censored2.gif" class="smilie" loading="lazy" alt=":censored2:" title="Censored2 :censored2:" data-shortname=":censored2:" /> is getting on my <img src="/community/styles/default/xenforo/smilies/group1/censored2.gif" class="smilie" loading="lazy" alt=":censored2:" title="Censored2 :censored2:" data-shortname=":censored2:" />ing nerves.</p><p> </p><p> </p><p> </p><p> </p><p>Brownbetty, ct scans are covered 100% if you utilize us imaging, 80% if you do it at the hospital, cancer facility, spine and specialty facility, etc that you are already at for an appt.</p></blockquote><p></p>
[QUOTE="BrownBrokeDown, post: 1433399, member: 46824"] Another :censored:ing Update: So Doctor's office called again, had me call again. Wow...Once again today the person i spoke with at Teamcare gave me an intirely different response. What this one said is Ultrasounds and X-rays even during procedures are only covered 80% as they are non-invasive whereas something like a scope (which is invasive) utilized during a procedure is covered 100%. She told me to have the doctors office go ahead and submit the appeal but that it would most likely be denied. Also, ultrasounds and x-rays are 80% regardless of where it is done as US imaging is for CTscans, mri's and petscans only. I then spent 15 mins explaining to her how I was sick and tired of getting different answers everytime i called. I also told her about the instance where i called spoke with one lady that said the file stated it was medically unnecessary. She then transfered me to someone i had spoke to before that said she had no idea where the other lady had seen that as it didn't say it anywhere. The one i spoke to today seemed amazed at everything i told her. She said that she almost would have understood if someone didn't give enough information, but was appalled at the idea that i had received so much "misiniformation". On another note. a month ago, my son sustained a grade 2 concussion. Wife took to hospital because he was having severe concussion symptons. At the hospital he kept repeating the same 2 questions over and over, etc. I owe $500 because it's not listed as life-threatening. Funny story though (that is sarcasm), last week someone I work with at my other job, had his daughter get dropped during cheerleader practice. Took her to an urgent care facility. They sent him straight to the emergency room. She had a "minor" concussion without a lot of the issues my son had. This :censored: is getting on my :censored:ing nerves. Brownbetty, ct scans are covered 100% if you utilize us imaging, 80% if you do it at the hospital, cancer facility, spine and specialty facility, etc that you are already at for an appt. [/QUOTE]
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