Here are some suggestions from Maureen Schilling
about dealing with insurance companies
I understand the frustration out there with Insurance companies, It
took me 5 years of vigorous campaigning to get my insurance company to
listen to me and cover my treatment.
Here are some suggestions:
- BE PERSISTENT - the squeaky wheel gets the oil
.I always made
several calls to my insurance 800 number, amazingly if I asked the same
thing of four different service reps I got four different answers. Find
someone you trust and that is helpful and ask for that one person.
- Document Everything: Take names and dates, every call you make.
Insurance agents have selective amnesia about coverage.
- Put it in writing. Follow up phone calls with letters. Overstate the
obvious and make quotes when available. CC as many doctors, company
executives that you possibly can - this lets the insurance company know
you mean business.
- Educate your Primary Care Physician: I had a draft of a letter asking
for coverage that I gave to my primary care physician so that it made it
easier for him to write the insurance company. I gave him issues of the
NLN newsletter and copies of articles on LE. When it comes to LE, you
probably know more than most primary care doctors do but they are to
embarrassed to admit that.
- Complain to your Human Resources Director: your company pays a lot of
money for your policy, let the HR Director know you are getting the run
around. See if they can put you in direct contact with the most senior
person at the Insurance company. Show them your documentation of phone
calls and letters to show how you have been working to get coverage.
- Change insurance companies: make sure the new carrier does not have
the dreaded pre-existing condition clause. Investigate all your
insurance options. You may have to pay a little more for better
insurance but they may cover all your expenses. In some cases the
cheaper HMO's offer more lenient LE coverage. Ask your LE specialist
what insurance companies have been paying for treatments.
- Change Primary Care Doctors: find an advocate! If you are not getting
the help or support you need to get coverage find another doctors. There
are many great doctors who unfortunately are poor administrators. Find a
doctor who will follow up with the insurance company for you, they all
hate dealing with the bureaucracy but it is part of their job.
- Assume Nothing: Insurance companies think they have all the answers
and will send you to who they consider to be the expert< often a
Vascular Surgeon or Massage Therapist who does not deal or treat
Lymphedema. Save yourself the time and call and find out what specific
treatments they give LE patients: if they don't have the answer don't
bother to go. MLD and CPT are specific treatments and massage therapists
must be trained by the reputed schools. If the therapist just gives you
a massage like you have a sports injury it is useless, in fact some
massages can worsen the situation. As for Vascular Surgeons, for the
most part LE has nothing to do with the vascular system and there is
really no effective surgery, they usually don't have much to say on the
subject.
- Try Again. Policies change, personnel changes, keep trying - they
will NEVER call you and let you know it has changed in your favor!
NOTE: In preparing the letter for your Primary Care Physician (item #4),
make sure this statement is included: "In my opinion, this
treatment is appropriate and medically necessary"
If you still have problems convincing your insurance company, there are
Cancer Patient Advocacy Groups which are pro bono. These wonderful
lawyers do perform successfully and do guide you through.
Other things to include in your doctor's letter:
- include any tests (lymphangiogram, venogram, catscan, doppler,
sonogram etc.) that have led to the diagnosis of Lymphedema
- patient's affected limb size vs. "good" limb size
- note vulnerability to infections, cellulitis, etc., if not
treated
- fibrosis of limb will continue and will make it make it increasingly
more difficult if not treated asap
- only treatment known to really be effective for such cases is MLD
/CPT
- note patient's physical AND mental health in jeopardy as depression
is common with disfigurement
- NOT a cosmetic remedy, LE can cause serious disability and infections
leading to long term hopspitalizations if not treated appropriately
- MLD or CPT is only acceptable form of treatment, massage therapy
without SPECIFIC training in Lymphedema can be contra-indicative to
patient.
- DO NOT: use terms like cosmetic, refer to unsightly appearance etc.
Stick to the medical situations, insurance companies could care less how
horrific it looks or feels
- STRESS: the disabling factors, the ineffectiveness of medications,
surgical stockings etc.
- STRESS that the fibrotic tissue must be softened to gain any
improvements and this can only be done by MLD /CPT