Posted by drummer (209.105.134.208) on August 21, 1999 at 06:41:29:
In Reply to: How to convince insurance to pay for O2 posted by Ueli on August 20, 1999 at 22:02:32:
Excellent memory, Ueli. Below is the reasoning for getting Oxygen paid for by Health Insurance Companies.
Most of us KNOW that oxygen is a terrific abortive treatment for cluster headaches. Most of our doctors KNOW that oxygen is a terrific treatment for cluster headaches. Here is the problem. It is very possible that Health Insurance companies don’t KNOW of oxygen being used for cluster headache treatment; they may also not KNOW about cluster headache.
It is imperative that our doctors inform the Medical Director of our Health Insurance company, with PROOF that oxygen is a proven abortive for cluster headache. Yes, when I saw my doctor he immediately wrote a prescription for oxygen. Yes, I took the prescription to my pharmacy. No, my Health Insurance company had never heard of a cluster headache, let alone oxygen as a treatment for clusters. Therefore, they would not pay for the prescription. Health Insurance companies are very good at following the rules”. RULE #1) – DO NOT PAY FOR ANYTHING THAT IS NOT PROVEN. My doctor then changed the prescription to read “migraine-variant” instead of cluster headache. The word “migraine” was KNOWN by my Health Insurance company. They reluctantly paid.
My job now was to educate my Health Insurance company’s Medical Director. It is not the job of my Health Insurance company’s Medical Director to seek out “things to pay for”. It is my job and my doctor’s job to educate my Health Insurance company. The Medical Director now has proof of Oxygen as a treatment for cluster headache. I am now a proud sufferer of cluster headaches as opposed to a frustrated “migraine-variant” sufferer. My Health Insurance company now follows RULE #2) – MUST PAY FOR EVERYTHING THAT IS PROVEN.