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+4
Love it

UPDATE 8:03PM
Wow!!!
So I sent out the snail mails to UHC and my senator and assembly man.

My son got the mail and....

A check was there from UHC. It seems they reviewed my case and got new information and approved it!!!!

I wonder if the girl on the phone had something to do with this as no new information was sent until today. From my last blog: I had broken down on the phone with this poor girl. It sounded as if she was holding back from crying. I told her i was sorry, that it was just such a long ordeal and had gotten to me. I wonder if she resubmitted things with this conversation.

I will be calling tomorrow to give them a heads up regarding my letter of appeal and to disregard it. And calling my representatives as well.

I also want to try and find the girl I spoke with 2 weeks ago. I think i may have an angel there!!

Wow!!!! I'm sitting here in amazement!!

******************************************************
Original post from this morning:

I will wait to threaten them with attorney later!! rofl
Here it is:
----------------------------

June 5, 2009

United Healthcare Appeals
PO Box 30432
Salt Lake City, UT 84130-0432
Fax# 801-938-2100

To Whom It May Concern:

I am writing in regards to a denial from your company for my wheelchair purchased when PacifiCare.  

The chair was purchased December 15, 2008 and was received January 31, 2009. I paid for the chair in full and filed the claim when the chair was received. In November of 2008 PacifiCare told me this chair was authorized and all I needed to do was to send the Doctor's scrip and the receipt for reimbursement of 80% of the chair per my membership terms. SpinLife is an out-of-network company.

PacifiCare became United Healthcare in January, so my claim was sent to you. I was re-asked for the receipt and doctor's scrip that had been sent in February, and sent them again. Then in May I called and was asked for a medical code for Multiple Sclerosis. Your claims rep called my doctor and got the code. I was told it would be re-sent in and there should be no more problems.

Last week I received our statement showing my wheelchair had been denied. I called and was told it was denied since United Healthcare did not authorize it. Well, it was not UHC when I purchased it was PacifiCare so how could UHC have authorized it. I told the first CS rep to check in the PacifiCare records and was told they did not have those.  

I am not sure what more I am supposed to do. I have sent the revised wheelchair receipt as some of the chair accessories were removed by me.  Will also be contacting the G.E. rep regarding this issue. It took 5 months to be told it was denied, when obviously this was known back in February.  

UHC should be honoring the contracts it took over from PacifiCare, Period!

The cost of the chair was 4590.20. My reimbursement should be 80% of that which is 3672.16, payable to me, Tracy A. Radford.

Attached is the doctor's scrip (revised due to losing the first one), updated wheelchair receipt with dates, my letter from February 11th, and your member service request form, and of course this page.  

Thank you, in advance, for your help in this matter.

Sincerely,

Tracy A. Radford

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  •  

Member Comments

    • 0 votes vote up vote up

      Coachmombabe wrote Jun 4, 2009
    • Good for you, Tracy! I hope this does the trick. I’m praying it will!



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    • 0 votes vote up vote up

      Laurie Zieber wrote Jun 4, 2009
    • Well written, MZT.   Go get ‘em!



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    • 0 votes vote up vote up

      (華娃娃) ChinaDoll wrote Jun 4, 2009
    • Great one.  Good luck.  

      How to spell script? scrip?

      Also, I will put  

      cc.  Attorney so and so

           Better Business Bureau

           Senator so and so



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    • 0 votes vote up vote up

      Mztracy wrote Jun 4, 2009
    • ty ladies, I am hoping...estatic



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    • 0 votes vote up vote up

      Deb Darby wrote Jun 4, 2009
    • Good, Tracy!



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    • 0 votes vote up vote up

      Lazylola wrote Jun 4, 2009
    • oh my, sounds like a hassle, I’m trying to avoid this hassle, I got a walker through freecycle, I’m hoping I can get a wheelchair as well, better yet, I’m hoping I won’t need a wheelchair...good luck with all this. I hate dealing with insurance...worried keep us posted.



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    • 0 votes vote up vote up

      Denise Richardson wrote Jun 4, 2009
    • Awesome and well written letter, I’m calling those things that be not as though they were in your favor MzTracy. You shall get the V.I.C.T.O.R.Y!!!! in this and God is going to give you double for your troubles meaning you’ll get refunded as well as the chair being paid for by the company I’m asking and believing all this for you in the name of Jesus. Please keep us posted on the outcome.happy



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    • 0 votes vote up vote up

      Jenni0811 wrote Jun 4, 2009
    • DITTO to all above happy

      You are one strong B*tch, Girl estatic
      You will come out VICTORIOUS!!



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    • 0 votes vote up vote up

      Vikki Hall wrote Jun 4, 2009
    • Tracy good luck with this mess.... Let me know if I need to call my Uncle Guido!



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    • 0 votes vote up vote up

      Mztracy wrote Jun 4, 2009
    • you all rock my world!! lol

      TY so much for your continued support!

      lola, I gave a walker and wheelchair to freecycle last year. it was a manual chair as i finally needed a power one. frown

      TY for the prayers neicy!! estatic

      Vikki, I’ll keep ya posted, tell Uncle Guido to be on call!! tongue out



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    • 0 votes vote up vote up

      Carolnphil wrote Jun 4, 2009
    • There are a few minor changes which I see should be made before faxing and mailing out, and I agree with CD about who gets cc’d on the final copy.  I will PM you.



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    • 0 votes vote up vote up

      Mztracy wrote Jun 4, 2009
    • ty!!
      I revised and changed a couple things.
      TY Carol for the idea!

      June 5, 2009
      United Healthcare Appeals
      PO Box 30432
      Salt Lake City, UT 84130-0432
      Fax# 801-938-2100

      To Whom It May Concern:

      I am writing in regards to a denial from your company for my wheelchair purchased when PacifiCare.  

      The chair was purchased December 15, 2008 and was received January 31, 2009. I paid for the chair in full. The claim was sent when the chair was received. In November of 2008 PacifiCare told me this chair was authorized. I needed to send the Doctor's scrip and the receipt for reimbursement of 80% of the chair per my membership terms. SpinLife is an out-of-network company.

      PacifiCare became United Healthcare in January, so my claim was sent to you. I was re-asked for the receipt and doctor's scrip that had been sent in February, and sent them again. Then in May, I called and was asked for a medical code for Multiple Sclerosis. Your claims rep called my doctor and got the code. I was told it would be re-sent in and there should be no more problems.

      Last week I received our statement showing my wheelchair had been denied. I called and was told it was denied since United Healthcare did not authorize it. Well, it was not UHC when purchased; it was PacifiCare. How could UHC have authorized it? I asked the UHC CS rep to check in the PacifiCare records, and I was told they did not have those.  

      I am not sure what more I am supposed to do. I have sent the revised wheelchair receipt, as some of the chair accessories were removed by me. The cost of the chair was 4590.20. My reimbursement should be 80% of that which is 3672.16, payable to me, Tracy A. Radford.

      UHC should be honoring the contracts it took over from PacifiCare, Period!

      Attached is the doctor's scrip (revised due to losing the first one), updated wheelchair receipt with dates, my letter from February 11th, and your member service request form, and of course this page.  

      Thank you, in advance, for your help in this matter.

      Sincerely,

      Tracy A. Radford

      CC:  

      GE Representative
      Senator George Runner
      Assembly Member Steve Knight



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    • 0 votes vote up vote up

      Cynthia Schmidt wrote Jun 4, 2009
    • I really hope this one does the trick Tracy. It makes me mad these people have been doinking around with this for so long. I don’t know how these insurance people sleep at night!



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    • 0 votes vote up vote up

      Mztracy wrote Jun 4, 2009
    • UPDATE  

      Wow!!!
      So I sent out the snail mails to UHC and my senator and assembly man.

      My son got the mail and....

      A check was there from UHC. It seems they reviewed my case and got new information and approved it!!!!

      I wonder if the girl on the phone had something to do with this as no new information was sent until today. From my last blog: I had broken down on the phone with this poor girl. It sounded as if she was holding back from crying. I told her i was sorry, that it was just such a long ordeal and had gotten to me. I wonder if she resubmitted things with this conversation.

      I will be calling tomorrow to give them a heads up regarding my letter of appeal and to disregard it. And calling my representatives as well.

      I also want to try and find the girl I spoke with 2 weeks ago. I think i may have an angel there!!

      Wow!!!! I’m sitting here in amazement!! estatic



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    • 0 votes vote up vote up

      Doreen XoXo wrote Jun 4, 2009
    • Great News Tracy... She truly is an angel. Im so glad this nightmare is behind you.  

      xoxo

      so hows Vegas looking for ya???



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    • 0 votes vote up vote up

      Tina Sickinger wrote Jun 4, 2009
    • Congratulations, Tracy!

      The insurance companies will try to screw you every chance they can. Like you , I have a LOT of medical expense and I fight them all the time.

      Anytme I have trouble with a pay off on a bill, I just threaten to turn them into the STATE AND FEDERAL INSURANCE COMMISSION.  

      I learned about them when my secondary insurance company didn’t want to pick up their part on my doctor bill from my hysterectomy. I mentioned the SFIC and the doc had her check before the week was out.  

      They don’t want to screw with the government and they don’t want to screw with US either, do they?



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    • 0 votes vote up vote up

      Mztracy wrote Jun 4, 2009
    • ty doreen!! I am still in a bit of shock here. The money goes back to my dad and back in my inheritance fund. YAY!! lol

      Hopefully all will be good Vegas time!! estatic



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    • 0 votes vote up vote up

      Mztracy wrote Jun 4, 2009
    • that’s just it twink, they had no idea i was doing this. all this happened today!! lol



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    • 0 votes vote up vote up

      Denise Richardson wrote Jun 4, 2009
    • Duhhhhhhhhhh MzTracy!!! Prayer changes things lol, I am so happy for you thank you Lord!!!!



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    • 0 votes vote up vote up

      Mztracy wrote Jun 4, 2009
    • ty ladies!!!!!  



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    • 0 votes vote up vote up

      Tina Sickinger wrote Jun 4, 2009
    • Awesome, baby! I had to go  back and reread!



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    • 0 votes vote up vote up

      Lazylola wrote Jun 5, 2009
    • Mztracy I am so happy to hear things worked out for you!

      I’m still hoping I won’t need a wheelchair, I have several times in the past, I’m trying to stay positive, yet at he sam etime realistic, Have a happy Friday! CYA in chat.estatic



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    • 0 votes vote up vote up

      Vikki Hall wrote Jun 5, 2009
    • Yeah! I am so happy that things finally worked out......



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    • 0 votes vote up vote up

      UK Girl wrote Jun 9, 2009
    • Hey Mz T just saw this and I’m really pleased for you - told you sobbing always works - plus they had to honor this as it’s a moral issue here honey ....

      Really happy for you estatic



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