Let me introduce you to Kari; a teacher, a loving wife and mother of two young children, newly diagnosed with Crohn's disease and prescribed infusions. Kari suggested that her insurance policy covered these types of treatment until she received an invoice worth about $ 20,000, and that was for ONE treatment. She will have to continue these procedures every five weeks !!!!! After a little success, Kari went into a panic, and we managed to get her account up to $ 411 with some of the following tips:
1. Go to your zen : The last thing Kari needed was an ulcer. With a few deep sighs and an action plan in place, she was ready to tackle this “billing monster.”
2 Get a copy of the detailed bill and medical records. A: We were able to remember some mistakes in payment, but we get a “clear picture” of what was done and whether there were any options. At Kari's house, it looked like her insurance had rejected part of the bill because the infusion center was not covered by her insurance.
3 Talk to the right person: Some institutions have advocates or social workers who can help find other payment options. Kari was able to check what we found through a lawyer at the facility. In addition, the lawyer pointed out some additional insurance options, in which Kari was qualified, but did not use it, so we immediately filled out all the documents using the object and received it in the correct plan within 2 months.
4. Talk to the doctor prescribing the doctor: Maybe there is alternative medicine or cheaper treatment? In the case of Kari, she had an adverse reaction to alternative treatments, so this was not an option. In some cases, the designated doctor may have free samples (usually about 2 months) that he / she can provide to you before a financial decision. The case of Kari was a bit more complicated, as she needed biology, which, as a rule, represents a slightly more complex therapy, since there are many factors, including the site of infusion.
5. Find out which financial aid programs exist: There are many “patience support programs” and / or “financial assistance programs” available for all situations. Check out these programs and qualify as soon as possible. Some websites that may be helpful include: NeedyMeds, Rx Access together, or a government pharmaceutical care program.
6 Go straight to the manufacturer: Many major manufacturers have an “access service manager” or someone else who can assist you in qualifying for some of these access and availability programs. Kari discovered that Kim, the access service manager for Remicade, she needed, went to Janssen Pharmaceuticals, Inc.'s website. and called number 888. For those who are not as smart, the doctor prescribing the doctor can help you give you the correct number by contacting a representative with whom they are associated with this pharmaceutical company.
7 Be pleasant and prepared: Before initiating any calls, take a deep breath and make sure that you record the following information so that you can provide it in a coherent way when the representative requests that it will make the call pleasant and fast:
- Your name and contact information
- Pharmaceutical recipe
- Desired location if necessary
- Insurance information (if you have insurance)
- Income level (a copy of your W-2 can provide this information)
Some programs may require additional information and you may not get the right person on the phone for the first time. Be patient and persevere. If your blood begins to boil, hang up and call again when you are calm, or call with your loved one.
8. Take notes: If possible, provide a name and contact information. Document the date and time of the call and summarize what was said, including any additional instructions given to you, as well as when a person can call you back. In the case of Kari, we were asked to call back to receive information that Kim was able to find out about her situation. In conclusion, Kim was able to find the site that accepts her insurance and determine that this site is accepting new patients. Kim also included Kari in an extra free service to remind her of her infusion dates.
9. Inhale and start: Now that everything is checked, Kari can get his injections and NOT go for medical debt. In addition, she knows to ask for a detailed bill and a copy of her medical records after each infusion so that she can keep track of her bills and be sure that there are no errors. If there is a discrepancy, she has an access service manager, Kim, to help her figure out and avoid the ulcer.
Today Kari is authorized patient without medical debt and an infusion center that is convenient for her home, which is covered by her insurance.
