Insurance claim denied, consultation in 5 days

Posted by cbdonlon @cbdonlon, Nov 16, 2018

Is there a Patient Advicate from Mayo Clinic that could help in this case. My husband has CVID with unknown bowel and allergy problems that neither his GI doctor not his Immunologist have been able to diagnose and treat. Our GP submitttd the case and referal for his consultation at the Mayo Clinic in Rochester and an appointment has been set for November 21st, but insurance declined it. The funny thing about Rapid City SD is that the specialists are too arrogant to admit they don’t understand what’s causing his symptoms and have outright refused to send in a referal for him. His immunologist went as far as to say we should wait a year and then he’ll consider it. This was two weeks before being notified that he sold his practice and is moving out of state.

Please. Is there anyone at Mayo who could help us?

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Hello @cbdonlon, welcome to Connect. I'm not sure if this will help but Mayo Clinic's Patient Account Services may be able to answer questions on Billing and Insurance. Hope this helps.

Charitable Care and Financial Assistance at Mayo Clinic
-- http://www.mayoclinic.org/patient-visitor-guide/billing-insurance/financial-assistance

Rochester, MN Charitable Lodging
-- https://www.experiencerochestermn.com/mayo-clinic/hotels/charitable-lodging/

John

REPLY

Hello @cbdonlon,

The link below, has resources to help you work through the insurance process with your insurer and with Mayo Clinic; the section on "Guidance for denied claims” might be helpful to you.

https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance
Insurance types
Approval from insurers
Guidance for denied claims
International patients
Uninsured (self-pay) or underinsured patients
Insurance FAQs
Glossary of billing and insurance terms
Contact numbers and online form

You could also call Patient Account Services (toll-free):
– Arizona
800-603-0558
– Florida
800-660-4190
– Minnesota
800-660-4582

And lastly, I would encourage you to visit this FAQ page about appointments and referrals:
https://www.mayoclinic.org/appointments/faq

Meanwhile, I’m tagging @jomama @dreamingingreen @jharsh @gratefulmom @tomewilson @colebernard – a few members who’ve talked about insurance claim denials and strategies in working with insurance in the following discussions:
– Insurance denied my claim https://connect.mayoclinic.org/discussion/insurance-denied-my-claim/
– Insurance Question https://connect.mayoclinic.org/discussion/insurance-question

REPLY

Hi @cbdonlon,

I just thought I’d also introduce you to @ldestella @miche @junegreen @xfirerose @gussie, as they’ve shared their insights about CVID, and I’m confident they will return with some more information that might help your husband.

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@johnbishop

Hello @cbdonlon, welcome to Connect. I'm not sure if this will help but Mayo Clinic's Patient Account Services may be able to answer questions on Billing and Insurance. Hope this helps.

Charitable Care and Financial Assistance at Mayo Clinic
-- http://www.mayoclinic.org/patient-visitor-guide/billing-insurance/financial-assistance

Rochester, MN Charitable Lodging
-- https://www.experiencerochestermn.com/mayo-clinic/hotels/charitable-lodging/

John

Jump to this post

Thank you @johnbishop , I was reading through that information last night and plan to call the MN branch billing department to see about filing for financial assistance before the appointment

REPLY
@kanaazpereira

Hello @cbdonlon,

The link below, has resources to help you work through the insurance process with your insurer and with Mayo Clinic; the section on "Guidance for denied claims” might be helpful to you.

https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance
Insurance types
Approval from insurers
Guidance for denied claims
International patients
Uninsured (self-pay) or underinsured patients
Insurance FAQs
Glossary of billing and insurance terms
Contact numbers and online form

You could also call Patient Account Services (toll-free):
– Arizona
800-603-0558
– Florida
800-660-4190
– Minnesota
800-660-4582

And lastly, I would encourage you to visit this FAQ page about appointments and referrals:
https://www.mayoclinic.org/appointments/faq

Meanwhile, I’m tagging @jomama @dreamingingreen @jharsh @gratefulmom @tomewilson @colebernard – a few members who’ve talked about insurance claim denials and strategies in working with insurance in the following discussions:
– Insurance denied my claim https://connect.mayoclinic.org/discussion/insurance-denied-my-claim/
– Insurance Question https://connect.mayoclinic.org/discussion/insurance-question

Jump to this post

Thank you @kanaazpereira I will read through those suggested links today - need all the information we can get since we aren’t able to call anyone and address this any earlier than Monday. By then we’ll only have 2 days to try to resolve this, and I desperately don’t want to cancel this appointment....

REPLY

Hello-
I found out that I have CVID after 2 yrs of constant Upper Resp Infections and over 35 antibiotics and ME PUSHING THE DOCTORS TO DIG DEEPER. It has been a wild ride trying to get someone to listen to me. I know, without ANY doubt, that the Ribaviron/Interferon treatments gave me this wicked disease. I have to have gamma globulin treatments every month for the rest of my life. They are not to bad depending on the nurse who runs the infusion.
During this time of yr...flu season, I wear a mask when I go out into public places i.e. grocery shopping, doctors, mall. CVID is when the big guys of the immune system; IgG, IgM, IgA are depleted. This is a permanent situation. Having CVID also makes your body extremely vulnerable to an autoimmune disease. I have Sjogren's syndrome. Any questions, pls don't hesitate to ask! Lisa A. DeStella

REPLY
@ldestella

Hello-
I found out that I have CVID after 2 yrs of constant Upper Resp Infections and over 35 antibiotics and ME PUSHING THE DOCTORS TO DIG DEEPER. It has been a wild ride trying to get someone to listen to me. I know, without ANY doubt, that the Ribaviron/Interferon treatments gave me this wicked disease. I have to have gamma globulin treatments every month for the rest of my life. They are not to bad depending on the nurse who runs the infusion.
During this time of yr...flu season, I wear a mask when I go out into public places i.e. grocery shopping, doctors, mall. CVID is when the big guys of the immune system; IgG, IgM, IgA are depleted. This is a permanent situation. Having CVID also makes your body extremely vulnerable to an autoimmune disease. I have Sjogren's syndrome. Any questions, pls don't hesitate to ask! Lisa A. DeStella

Jump to this post

Thank you @ldestella I appreciate the support. My husband was coughing up pools of blood and fighting for his life with a case of pneumonia before anyone thought to test his antibodies.... 8 years of this, 8 years and it took watching a 30 year old man dying on a hospital bed before anything helpful was done. This small ignorant town will be the death of him... so the appointment to Mayo Clinic was like a god send, but insurance declined it. After everything, they would rather pay for useless test after test than allow him to be seen by pioneers of medicine? I don’t know how to pay for his treatment or appeal to insurance but he needs to go to Mayo...

REPLY
@kanaazpereira

Hi @cbdonlon,

I just thought I’d also introduce you to @ldestella @miche @junegreen @xfirerose @gussie, as they’ve shared their insights about CVID, and I’m confident they will return with some more information that might help your husband.

Jump to this post

REPLY

@cbdonlon, I just read your post about your husband. I also got diagnosed a little too late with CVID. Getting the IVIG infusion was a huge help to me. It was life changing. Even though, the damage that was done in the past by the frequent infections are still causing problems. I am still trying to fight an infection in my lungs call MAC. MAC can cause you to cough up blood. I also have Bronchiectasis. Being able to talk to others with CVID has also helped me. Hope your husband can get the help he needs. It sounds like he is very sick.

REPLY
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