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Re: The Insurance-DME secret


Posted by r.e.m.quest on February04, 2000 at 06:13:05:

In Reply to: The Insurance-DME secret posted by CherylB on February02, 2000 at 18:00:07:

Thanks for posting the info on the CPT codes, CherylB. It goes a long way towards explaining what I thought must be a learning disability on the part of my ins co. The explanation given for denying my doctor's prescription for a smart CPAP was that I already have one. On the appeal we worded it as though we were speaking to a child explaining that, no, I don't have a smart CPAP, I have a conventional CPAP which is just not getting the job done consistently. We were very specific in detailing the differences between "smart" and conventional CPAPs and why my doctor felt a smart CPAP was a medical necessity. They again denied the claim explaining in one sentence their reason - I already have one. ARGH!

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