← Return to Autonomic Disorder and Coverage for Mayo's Pain Rehab Program

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@kari3057

Hi Colleen, thank you (and I thanked you in a related response to my post)

My son wants to attend the Rochester program. (and bring his snowboard for the weekends :). We have family in the Twin Cities and Madison so we could see them as well.

in the meantime, I've spent more time researching and on phone calls.

I need Mayo to submit a formal preauthorization request to my insurance company. They haven't done this. Without a formal request, CareFirst BCBS has nothing to consider/authorize. Our week of Mayo appointments in early October were fully covered. (my only bill is a $35 copay.) which is why this is so bizarre.

We have a case manager. She and her higher ups are willing and able to help but they can't do anything without Mayo's precertification request. They can see a precert request from another provider from the spring. But BCBS has no record of a Mayo precert request.

I spoke with Mayo's precert team and was told they couldn't make a request. But BCBS evaluates preauthorizations/pre cert requests. and they make redeterminations if denied. They can't do anything without a formal pre-cert request.

I can't make the request. My case manager and her bosses also can't.

How do I get Mayo to do it?
thanks,
Kari

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Replies to "Hi Colleen, thank you (and I thanked you in a related response to my post) My..."

Hi Kari,
It sounds like you have already spoken with a coordinator at Billing & Insurance
- Patient Account Services toll free at 844-217-9591 Monday through Friday

I have a couple of suggestions:
1. Request an appointment with a Mayo Clinic social worker. They can often act as mediators with challenging insurance cases.
2. Contact the Office of Patient Experience
If they can't directly help you, they can direct you to the right place internally at Mayo Clinic to get the help you need.
Mayo Clinic Office of Patient Experience
https://www.mayoclinic.org/about-mayo-clinic/patient-experience
Phone: 844-544-0036 (toll-free)
Email: opx@mayo.edu