Insurance reimbursement ... crap.

And hopefully Phil will end up in the handcuffs that he deserves.

 

Sorry but no one person will be be able to completely reverse the downward decline of reimbursement rates and MCOT acceptance by insurance providers. Cardionet needs some big price and billing model adjustments to make MCOT more viable because no, those insurance issues are not going away. They're going to get worse.

 

The insurance issues are going away. Now that they let Phil go and Jareer is in charge, this will get cleared up

Whoever posted this must be eating lead paint chips!

 

The insurance issues are going away. Now that they let Phil go and Jareer is in charge, this will get cleared up.

Are you kidding yourself?....the DOJ is all up cardionet's butt!!...their insurance issues are just beginning!!

 

And hopefully they give Phil his well deserved set of silver bracelets!

 

Jareer knows as much about Payor Relations and contracting with insurance companies as he does about managing sales people.......ABSOLUTELY NOTHING!

 

On Aetna's website regarding coverage of the MCOT, it clearly states that it's considered experimental and will not pay for it, as does UHC, Cigna and some BCBS plans. It is covered at a much higher rate from Medicare, but that's because someone higher up at CardioNet is sleeping with someone higher up at CMS/Highmark. Why do you think they're offices are so close to one another? And the fact that Cardionet wrote most of the CMS policy on MCOT coverage (they're cited several times in the policy) as well as denying the eCardio evolution for coverage (one of their bigger competitors), AND THE FACT THAT CARDIONET IS UNDER INVESTIGATION FOR YEARS OF FRAUDULENT MEDICARE BILLING PRACTICES!!! CardioNet had someone on the inside, illegally authorizing all these reimbursement payments to go through............
As far as monitors are concerned, one of the first commentors was right, you could always get a looping cardiac event monitor that is not experimental and is universally covered by insurance. Salesmen sold you on the MCOT because it's suppose to reimburse at a higher rate and get them higher commisions. However, the looping cardiac event monitor (braemar 920er, for example) uses the same detection algorithms for arrhythmias, is covered by insurances, but is reimbursed at a lower rate. This is why Cardionet lied to you, to get the higher reimbursement, when they do actually carry the braemar er920af.

How to get the insurane bill covered for cardiac event monitoring services is to:
1) Tell your primary care physician; there may be an issue with preauthorization or referral necessary from the PCP to authorize use of the monitor. It's the same type of referal authorization necessary for some plans for you to go see a specialist such as a cardiologist.
2) Tell your cardiologist; if the referal from the PCP to see a cardiologist was necessary, the same referal is necessary to have a cardiac diagnostic test performed. The same referal may work in providing payment.
3) Send your insurance company an appeal letter. Cardionet may appeal the insurance decision several times and get a denial every time, but an appeal letter directly from the patient works more times than one from the monitoring service; if you have a copy of the referal from the pcp to the cardiologist, this will make your case that much stronger for reimbursing for coverage. In the letter, also mention how you did not know this was out-of-network or that you were misled into thinking this was a covered service; use names of the reps you spoke to and the dates you spoke to them.
4) Send 2 more appeal letters if the first does not succeed.
5) Send a letter to the Better Business Burea; they will intervene with a legal team if necessary; of course, they're already being investigated by Medicare and the Department of justice, so it may be a huge line you have to wait in, but at least when civil litigation comes in, a group lawsuit may help you in eliminating the cost of the service.
6) Research your case against cardionet; chances are that they're doing this to a lot more patients than just yourself, and a class action lawsuit may help you.
7) Go to this website to lodge your complaint (This is HILARIOUS.... THERE's AN ACTUAL WEBSITE JUST FOR CARDIONET COMPLAINTS) http://www.complaintnow.com/CardioNet,-Inc.-Complaints/complaint/business/Business_ID/display/4509

 

Who do you think trained Jareer, he's just as crooked as Phil and the rest of the Cardionet scamming coniving backstabbing squabbling crybaby liars

 

Phil and Ann,
Please get a job, or clean the house and stay off this site! Really, we have had enough of you and your screw-ups!

 

Some of u guys are asses. Don't take your anger out of forums

 

what a returd. You are replying to a 7 year old thread