View source for Dealing with insurance & Medicare

==Buying Out-Of-Network With Insurance Coverage==

This section is adapted from a post by member Jerry Sends [http://www.apneaboard.com/forums/Thread-split-CPAP-Machine-Choices-Jerry-Sends-Buying-CPAP-Out-Of-Network Buying CPAP Out Of Network]
What I learned from my skirmish with the insurance "customer service "representatives:
* Don't take no for an answer if insurance refuses to pay or wants to pay at out of network rate, ask for a supervisor  
* Ask for the supervisor of the supervisor if you aren't getting anywhere  
* The CS lower level CS folks have little power, upper level, significant. 
* You may have a representative from your employee group within the insurance CS chain, we did.  A Very helpful person.  
* You will have to jump through hoops, document the time & steps taken, do your due diligence & explain how frustrating the process has been. 
* Insurance companies have the power to make reasonable exceptions if they know all the facts & about your medical complexities that put you at greater risk of landing in the hospital  
* You can request a "Benefit Level Exception" to move equipment purchases/service from out of network to in network if there are extenuating circumstances such as no machines available locally or long wait lists. 
* If denied, write an appeal letter stating extenuating circumstances & medical complexities.  This is reviewed by a separate medical board. 
* You can always submit for reimbursement even if they may deny, sometimes it slips through.  
* Insurance companies really want to avoid 
significant time/paperwork and/or a complaint to the state medical commissioners office.  Be the squeaky wheel.