Tuesday, May 8, 2012

Insurance Pended

We have received a request to approve the services identified above (the sleep study).  However, at this time we do not have enough clinical information regarding your health status to determine whether the services are covered by your plan.

If you and your physical decide to continue with the treatment, we cannot guarantee benefits will be covered.

In order to process your request the following information is requested:
  • MD office notes and exam findings
  • Diagnostic testing results
  • Previously tried treatments and medications
  • Any other information you feel would support this request
  • Does the member have narcolepsy?
  • Is the member suspected for idiopathic hypersomnia?
  • PLEASE USE ATTACHED PROVIDER TOOL (wasn't attached to my copy so I hope they put it with the doctor's copy)
We have 2 business days to complete your request after you provide us with the additional clinical information.  If you do not provide us with the additional clinical information that has been requested, we will review by 06/20/12 based upon the information you have provided thus far.

So I've sent a message to the sleep doctor's office asking if they needed anything from me to help get this processed.  I hope a rush is put on this so a doctor can find out what's wrong with me and get a workable treatment plan.  I'm tired of being tired....10 years is too long!

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