Yesterday... Kinda Long & Boring | Arthritis Information
Friday morning I got woke up by the phone, I answered it and it was the billing lady, Wanda, from RD's office. She called to inform me that I will be recieving a bill in the mail for services. I was like ok. Then she proceeded to tell me that Medicaid had denied the PA for Remicade, but paid for the medical services. I was like how and why? She said she did not know. Then... she said when I received the bill in the mail, I did not have to pay it right away, because my RD is suppose to be sending another PA form in to get Medicaid to PA the Remicade and pay my co-pay.
So... after I woke up and felt up to messing with the state folks, I called the Prior Authorization office, and left a message for someone to call me back. I called around 4pm, so I figured it would not be until Monday when I got a call back. The lady called me back 3 mins to 5pm.
I asked her if she could tell me why my PA for Remicade was denied. The lady said the computer did not show any PA's forms received for Remicade. I was like huh? She said all she saw going on with Remicade in my file was the the billing from RD's office had submitted charges and were denied because no PA for that medicine had been received. She said once a PA is received by my RD that they will pay the bill.
I remember being told way back in October that Medicaid had approved the PA for Remicade and that it was just BC/BS that they were waiting on. Then in Decemeber, they said Medicaid had not approved the PA.
But according to Medicaid they have NEVER received a PA for Remicade.
Oh and my other meds that require a PA, Lidoderm patches & Soma, well Medicaid is STILL waiting for my RD to send in PA forms for those as well.
I am kinda glad I am not needing those meds THAT bad, as I still have my other meds to tide me over. But Still if I would have needed them I would have been SOL!
So... Monday I have to call RD's office and get them to send in PA forms to Medicaid. And hopefully this will all be straightened out, until the next medicine RD RX's me that needs to be PAed by Medicaid. *rolls eyes*
Sounds like a mess. I am sure it will get straightened out. I almost can not type. So my spelling may get worse. Maybe you are faster than they are. Someone has maybe not done there job yet. I was my brothers payee and sometimes i heard an excuse the doctors office does not know how to fill out the billing form correctly. Then apparently they did not ever want to fill it out correctly. Certainly you will get it straightened out. I am so happy to live in a country with universal health care it is not even funny! _popupControl();
PD, I've never had the kind of problem Joonie is having. It's not how things go typically.
Joonie, did someone at the office drop the ball? At least you know you aren't going to be stuck with the bill :)
Well... it got all screwed up way back when I first started going to the new RD. New RD had just had some of her staff to quit and she was having others who do not normally do those jobs doing them. Then she got a new billing lady, and it appears this billing lady does not know how to do certain things.
As for the PA's I have no idea who is in charge of getting those done. But will find out Monday, that is for sure!
RD still has not gotten a new office manager. Her other one quit to to be home with her new baby.
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