Saturday, October 9, 2010

Persistence Provides a Passel of Pennies

Alright, so remember how disheartened I was to find out my insurance would not cover the new pair of orthotics I need? Well I picked my sad self up off the floor and thought, "I'm just going to check this out . . . what if there's a way?" I got the idea to try again from all the reading I did on the Internet, trying to decide whether I really needed a new $500 pair. From what I read, people with high arches and the foot structure that causes bunions really need to wear good, custom made orthotic support, if they don't want their feet to worsen rapidly. Considering my goal is to keep my left foot from getting as bad as my right foot, I decided I needed to get them. I noticed that the articles I read said that sometimes insurance pays, and sometimes not, depending on the diagnosis. Both diabetes and plantar fasciitis are often covered reasons for getting orthotics. I recalled that my MRI report mentioned "mild to possibly moderate plantar fasciitis. The posterior plantar fascia is moderately thickened and edematous posteriorly."  So I called my insurance company to see if orthotics were covered for fasciitis, and I found out they are covered for any condition, as long as a doc prescribes them. When I asked why my doctor's office was told no, she said, "Oh, they use the provider line, which is staffed in India. Those reps sometimes don't pull the correct information. So I'm giving you this confirmation number and I'm typing 'ORTHOTICS ARE COVERED' in all caps on your file.  Ask your doctor's office to verify benefits again, and they'll see this note."
No comment on how wrong that is on so many levels; just GLAD I'm going to get orthotics sooner rather than later, now that I know they are covered! 

1 comment:

  1. That is GREAT news!! I'm glad you continue to be proactive about this. It's always a good idea to double-check with your carrier instead of just taking the clinic's word for it. Cut out the middle man and you might just get the answer you had hoped for!

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