PRE-EXISTING CONDITIONS iNSURANCE PROGRAM RESPONSES
James Fenton
Description
Collection
Title:
PRE-EXISTING CONDITIONS iNSURANCE PROGRAM RESPONSES
Creator:
James Fenton
Date:
2/25/2013
Text:
Original Message:
This is a short story about our first encounter with ObamaCare. We received a referral for a new TT prosthesis. The patient presented his United Healthcare card and we began to investigate. It turns out that his coverage is through the pre-existing program.You may remember that pre-existing conditions will no longer be a deterrent to getting insured under ObamaCare. With this coverage, there is a significant deductible and there is a significant out of pocket expense limitation. There is need for a pre-authotization. As it was explained to us, this program is funded by the Federal Government AND WHEN THE FUNDS ARE EXHAUSTED, YOURPRE-AUTHORIZATION IS USELESS! THE INSURANCE COMPANY IS ONLY A CONDUIT TO DISTRIBUTE FEDERAL MONEY.
The nice lady from UHC assured us that there was probably money still available as it is early in the program but also allowed that it is just a matter of time before the funds are exhausted. So, yes, there is coverage. There was never any guarantee by Obama that with a pre-existing condition, you would be able to find someone hungry enough to gamble that they would get paid and provide the services. BTW, as far as I can tell, there is only one bucket full of cash for ALL providers. LET THE PROVIDER BEWARE!
Hopefully, enough of our field will read this message and then investigate on their own to make the right decision concerning this program. 1 800 220-7898 is the number that we called for the Pre-existing condition insurance plan at United Healthcare.
Jim Fenton, LPOMiami, FL
RESPONSES:------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
I cc'ed someone I know that ran into the same thing and it was a bogus claim by Cigna to get him tricked into joining Linkia of having them process the claim. As it turned out the more he looked into it the more he realized that what Cigna was telling him wasn't true. I believe those are the details but before you proceed any further I suggest you connect with Jeff Boonstra and learn from his experience. If the benefits are available with the patients plan, OUT OF NETWORD can be a more profitable way or treating these patients.-------And you believe anything UHC tells you. It won't be the last UHC gives wrong info.-------I forwarded your message to a staunch supporter of Obama Care who is a friend of mine. I thought that you would enjoy his response.
There is no pre-existing program in Obamacare ie the Affordable Care Act. There are insurance exchanges and medicaid expansion and new regulations that says that all programs public and private cannot deny coverage based on pre-existing conditions. This is a scam scare tactic, not the last we will see.
---------Good post, Jim!-------Please tone down your political rhetoric!--------Check out this site from the US Government. Straight from the Horses Mouth. I cannot believe this: 1. Click this weblink: <URL Redacted>. Click on pcip.gov link in the middle pragraph 3. A notification pops up and explains why they stopped enrollment and further explains the high cost of expenses and limited funds from Congress. Typical Lies from our own Government. FRAUD and just as bad as Medicare RAC audits. No Oversite. PLEASE pass this information along so everyone can see the actual proof!------- i believe the pcip plans are meant as a temporary conduit to 2014 when the regulation requiring private insurance companies not to take preexisting conditions into account when determining whether to offer coverage is activated. The fact that there is a finite appropriation for this program is very troubling, but atleast it is only temporary. Last year they cut the premiums and deductibles because noone was signing up. I haven't heard whether those cuts led to an increase in enrollment or not, but it wouldn't suprise me if funding were to run out at some point this year.
------Thank you Jim for this important message. Just like most of the political
solutions, it is thin as a pixel.
This is a short story about our first encounter with ObamaCare. We received a referral for a new TT prosthesis. The patient presented his United Healthcare card and we began to investigate. It turns out that his coverage is through the pre-existing program.You may remember that pre-existing conditions will no longer be a deterrent to getting insured under ObamaCare. With this coverage, there is a significant deductible and there is a significant out of pocket expense limitation. There is need for a pre-authotization. As it was explained to us, this program is funded by the Federal Government AND WHEN THE FUNDS ARE EXHAUSTED, YOURPRE-AUTHORIZATION IS USELESS! THE INSURANCE COMPANY IS ONLY A CONDUIT TO DISTRIBUTE FEDERAL MONEY.
The nice lady from UHC assured us that there was probably money still available as it is early in the program but also allowed that it is just a matter of time before the funds are exhausted. So, yes, there is coverage. There was never any guarantee by Obama that with a pre-existing condition, you would be able to find someone hungry enough to gamble that they would get paid and provide the services. BTW, as far as I can tell, there is only one bucket full of cash for ALL providers. LET THE PROVIDER BEWARE!
Hopefully, enough of our field will read this message and then investigate on their own to make the right decision concerning this program. 1 800 220-7898 is the number that we called for the Pre-existing condition insurance plan at United Healthcare.
Jim Fenton, LPOMiami, FL
RESPONSES:------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
I cc'ed someone I know that ran into the same thing and it was a bogus claim by Cigna to get him tricked into joining Linkia of having them process the claim. As it turned out the more he looked into it the more he realized that what Cigna was telling him wasn't true. I believe those are the details but before you proceed any further I suggest you connect with Jeff Boonstra and learn from his experience. If the benefits are available with the patients plan, OUT OF NETWORD can be a more profitable way or treating these patients.-------And you believe anything UHC tells you. It won't be the last UHC gives wrong info.-------I forwarded your message to a staunch supporter of Obama Care who is a friend of mine. I thought that you would enjoy his response.
There is no pre-existing program in Obamacare ie the Affordable Care Act. There are insurance exchanges and medicaid expansion and new regulations that says that all programs public and private cannot deny coverage based on pre-existing conditions. This is a scam scare tactic, not the last we will see.
---------Good post, Jim!-------Please tone down your political rhetoric!--------Check out this site from the US Government. Straight from the Horses Mouth. I cannot believe this: 1. Click this weblink: <URL Redacted>. Click on pcip.gov link in the middle pragraph 3. A notification pops up and explains why they stopped enrollment and further explains the high cost of expenses and limited funds from Congress. Typical Lies from our own Government. FRAUD and just as bad as Medicare RAC audits. No Oversite. PLEASE pass this information along so everyone can see the actual proof!------- i believe the pcip plans are meant as a temporary conduit to 2014 when the regulation requiring private insurance companies not to take preexisting conditions into account when determining whether to offer coverage is activated. The fact that there is a finite appropriation for this program is very troubling, but atleast it is only temporary. Last year they cut the premiums and deductibles because noone was signing up. I haven't heard whether those cuts led to an increase in enrollment or not, but it wouldn't suprise me if funding were to run out at some point this year.
------Thank you Jim for this important message. Just like most of the political
solutions, it is thin as a pixel.
Citation
James Fenton, “PRE-EXISTING CONDITIONS iNSURANCE PROGRAM RESPONSES,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/234724.
