Insurance vs. Product Providers

Monica.TMonica.T Posts: 91Member ✭✭
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I use to get so frustrated jumping through all the hoops and paperwork insurance requires for even the simplest item. And would get so irritated when insurance would deny things the doctor or therapists said my son needed; then I begin to realize why insurance companies are often reluctant to sign-off on things without first doing an extensive inquiry. I'll give you an example : When my son finally received his wheelchair, a ZippyGS; the company that provided and delivered the wheelchair charged the insurance almost $8,000 for the chair, back and seat cushion. When I looked it up online - if I had ordered it myself it would have only cost $3,700. Over billing is why insurance companies hesitate to just approve whatever items or services are ordered by doctors and therapists. So it's not always the insurance company that is to blame, often it's the providing company over charging is why insurance will deny a request.

Another issue with providing companies is I've noticed they seem to be very slow about delivering items insurance has paid them for. Example: Insurance first denied then finally approved my son's footholders. In fact they paid the providing company for the footholders back on Oct.14th 2018 but the providing company (IOW) didn't deliver them until today!

While I've had issues dealing with insurance delays, I now realize they are not always the problem.

Comments

  • Patricia_PRCPatricia_PRC Posts: 2Moderator Moderator
    First Comment Photogenic
    We couldn’t agree with you more! That’s why the Reeve Foundation’s advocacy priorities include Complex Rehabilitation Technology (wheelchair and equipment) and healthcare coverage and care. If you want to bring your knowledge and experience to effect change in our community, please consider becoming a Reeve Advocate for Change.

    We are also happy to help you sort through your insurance issues. Please contact our Information Specialist to get personalized guidance and assistance.


    Patricia E. Correa

    Associate Manager, Information Services and Translation
    Christopher & Dana Reeve Foundation

    Have a question about paralysis and need personalized assistance? Contact our Information Specialists: www.ChristopherReeve.org/Ask
  • jaarchjaarch Posts: 42Moderator Moderator
    25 Likes 10 Comments Name Dropper 5 Awesomes
    I have seen many examples of items labeled as "medical" having their cost increased 400% or 500%!! I think it should be illegal to charge an insurance company a different amount than a private party just for the sake of making more money. I'm pretty fortunate to be mechanically inclined and have access to a fairly well stocked workshop, I have been able to make some of my own parts and accessories for a fraction of the cost and it gives me something to keep my mind engaged. 
  • sam_msam_m Posts: 0Member
    I like your post! and appreciate it.You have posted a incredibly detail document

  • Monica.TMonica.T Posts: 91Member ✭✭
    25 Likes 10 Comments 5 Awesomes Photogenic
    Patricia_PRC  Thank you for the links , :)
  • Monica.TMonica.T Posts: 91Member ✭✭
    25 Likes 10 Comments 5 Awesomes Photogenic
    jaarch I'm not very handy when it comes to mechanical stuff but I have learned that Velcro is a must have LOL I've used it to create fasteners for calf-straps to backpack stabilizer, and as shoe-holders until my son's real shoe-holders were delivered.
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