PowPow Posted February 11, 2014 Report Posted February 11, 2014 We got a letter today that my child was being assigned a case manager. anyone (joybop?) want to decode this one for me? Is this the beginning of the end of our smooth coverage for all recent AE tx & medications? I am a little unsettled. But then again, I have been our own case manager for 5 years+ now and there is no way someone else, who has not been through this could do a better job. I am not typically that confident, but I know this is true! should I be suspicious?
NancyD Posted February 11, 2014 Report Posted February 11, 2014 I have had GREAT success having a case manager with two different insurance companies. We got many things approved that I never thought we would and it was quick. It's so much easier dealing with one person who knows your situation. Just remember, everything you say is recorded so be careful.
Hrosenkrantz Posted February 11, 2014 Report Posted February 11, 2014 Powpow, before I had ever heard of pandas, when my son was wracking up a lot of speech therapy and OT costs, I got a letter like that from our insurance. I ignored it and went about my business of managing my son's care the best I could. I don't think I ever heard from the case manager, and I continued submitting my expenses without any issue. The both times my son's IVIGs were appealed, a case manager was assigned, and I did speak to her about the process.
PowPow Posted February 11, 2014 Author Report Posted February 11, 2014 Thank you to both of your for talking me down
Hrosenkrantz Posted February 11, 2014 Report Posted February 11, 2014 We all have PTSD from this process -- its easy to assume everything is going to fall apart because who would hav ever thought we'd wake up one day with a kid who changed overnight?
Hopeny Posted February 11, 2014 Report Posted February 11, 2014 (edited) My ins calls and sends me letters, it's optional and I ignore them Edited February 11, 2014 by hopeny
pr40 Posted February 11, 2014 Report Posted February 11, 2014 powpow, at Harvard Pilgrim, case manager is a person who manages your appeal. when we appealed a decission hp made, case manager handled insurance side. she had no say in medical managment of our child.
PowPow Posted February 11, 2014 Author Report Posted February 11, 2014 I think they are getting tired of thousands of dollars a month for infusions and are taking notice
qannie47 Posted February 11, 2014 Report Posted February 11, 2014 If you have been assigned a case manager I think that is a positive thing as well. Now you will have one person with whom to deal with. You will form a relationship with him/her and will be able to relate to them about your situation on a more personal level, as opposed to being just a bunch of words on a computer screen. We had a case manager, but it was through a peer review company that was asked to evaluate my son and help determine what was medically necessary. I would not ignore it. It would not help anyway, if they decided to assign you a case manager, you now have one.
Hrosenkrantz Posted February 11, 2014 Report Posted February 11, 2014 (edited) <<I think they are getting tired of thousands of dollars a month for infusions and are taking notice >>Maybe the letter saying "you have been assigned a case manager'' is like when the mob sends you a dead fish to try and intimidate you.(joking, but thats how i feel about insurance companies sometimes)... Edited February 11, 2014 by hrosenkrantz
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now