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Insurance, Minimed and Third Party Payors?

Discussion in 'Insurance Issues' started by MelissaC, Nov 3, 2008.

  1. MelissaC

    MelissaC Approved members

    Joined:
    Jun 13, 2007
    Messages:
    735
    :eek:

    Ok... so back in September when we ordered Avery's pump and CGMS with Minimed we knew that we would have to pay about $2500 out of pocket for everything... we have a lovely $2000 DME cap...
    so... we get our pump and get hooked up and never get a bill from Medtronic.

    I get an EOBfrom my insurance telling me that I owe $3,985.71:mad::eek:... and get this... I don't owe it to Medtronic, I owe it to some 3rd party payor that Cigna Healthcare employes to "negotiate" prices with minimed!

    WTF?! Basically in a nutshell... Medtronic was pad $4,631 on 10/30 from this third party that cigna paid. In turn, they are billing me $3,985.71 - sounds to me like a scam and the lady at carecentrix (the 3rdparty) tells me in a not so nice way that there is nothing I can do about it!

    Watch me lady! I am so po'd right now..... I will fight this to the end especially when I signed and AOB with Medtronic NOT with this Carecentrix and the minimed people dealt with Cigna direct!

    Do ya'll think I have a legal case here or has anyone else been burned by the insurance companies?
     
  2. Seans Mom

    Seans Mom Approved members

    Joined:
    Oct 10, 2007
    Messages:
    2,279
    Call Medtronic about it. Ask for the person who deals w/ your insurance. We have Cigna also although our DME provider is Gentiva (like carecentrix is for you). Our DME is 100% w/ no deductible or cap, so after we got the pump, imagine my surprise (much like your I'm sure) when we got a EOB from Cigna saying they would only pay 80% because it was billed out of network. Yep, I was like ....:eek: and :confused:. So I called Animas (our pump) and finally got an explanation........ They screwed up and didn't bill it right. The outcome... Animas ate the cost since it was their mistake. All they really had to do was send the bill through properly with Gentiva but they decided to eat the cost instead for whatever reason. So again I was like this :confused:.
    Anyway, that was long story for short answer, sorry. lol Call Medtronics see what they can tell you.
     

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