Welcome...

Welcome to the place I come to complain about my psoriasis.
Please feel free to comment on any post, be it a response to something I've said or to share your own story/thoughts/advice/etc.

Monday, August 26, 2013

My Health Insurance Company is a Pain In My...

Everything was perfectly lined up for me to get the light box I wanted:  my dermatologist fashioned a letter of medical necessity for me and wrote a prescription for the phototherapy unit, I filled out the required paperwork on my end, and the representative from the lightbox company was doing the dirty work of fighting with my insurance company to get them to cover the lightbox as an in-network provider, though they were actually out-of-network (which means they would cover 80% instead of 60%).

I was really excited about the lightbox I chose.  It was a full body unit that closed up and looked like a cabinet.  I could even choose the finish and I wanted a nice wood to look more like a cabinet.  But then I get a call from the representative...with bad news.  Not only was my insurance company not willing to view the lightbox company as an in-network-provider, but they weren't even willing to work with them as an out-of-network provider.  WTF???

I thanked the rep for all of her hard work and let her know I appreciated her fighting for me.  I then spent several hours on the phone.  I found out that there was only one lightbox model that my insurance company would allow me to get.  It's not as nice as the one I was originally looking at, and I can only treat half my body at a time, so I have to do two treatments in one sitting to get my whole body.  But anyway, it took 3 weeks of communication with all 5 parties involved: the insurance company, my dermatologist, the medical equipment provider, the unit manufacturer and myself.  My dermatologist re-wrote a new Rx and updated my letter of medical necessity.  I filled out new forms.  Back and forth, forth and back with emails and phone calls.  It felt like it was never going to happen.  And then I hear the good news:  THIS LIGHTBOX WAS COVERED 100%!!!  Well, because my out-of-pocket maximum was met, which was met very quickly this year by having a baby.  Making this the perfect year to get a lightbox!

So last Wednesday the light box showed up late afternoon, in two large boxes.  I anxiously waited for my husband to get home from work so we could put it together.  I read through the manual and all of the included materials.  This lightbox comes preloaded with a set number of authorized treatments and then I have to get a code from my dermatologist for a new prescriptions worth of treatments.  Interesting...

So first thing Thursday I call my derm.  I am told my derm received a packet from the lighbox company and we need to sit down and plan a course of treatments.  I get an appointment for first thing the following morning.

I leave the appointment with a plan of action for a course of treatments and a follow-up appointment for two months later.  I get to go home and have my first phototherapy treatment session IN MY OWN HOME!  In a lightbox that I  own!  Mine!  Forever!  Fully paid for by insurance!

So I'm pretty stoked.  I've done two sessions now and my skin is already reacting.  It's not vanishing, but I can tell the plaques are thinning.  The manual states that about 20 sessions are usually required to see it go bye-bye.  We shall see.  I don't think it'll take that long.  But I'll let you know!

Ahhhhh.  I'm so glad I don't have to drive 45 minutes each way to go for a minute and a half treatment 3 times a week!  What a time saver.  This is great.

Oh, BTW this is the lightbox I got: http://www.natbiocorp.com/panosol-3d.htm
I like that it doesn't take up loads of space and plugs into a regular electrical outlet.

Anyway, I'll be back with an update another time.

:)

4 comments:

  1. Really interesting stories here I've read. Thanks for sharing it. Can't wait to see your next update here on your skin issues. But for your additional information about treatment, why don't you try using dead sea salts from San Francisco Salt Company which is good in psoriasis. I've been using this and now the results was really amazing and my skin are clear now. Dead sea salts helps my skin feel hydrated and less itchy. See how it works at http://www.sfbsc.com/psoriasis-treatment and save 5% off and free shipping on your first order of Dead Sea Salt with coupon code: skincare5 at checkout.

    ReplyDelete
  2. Hi Lissa,
    My name is Jackie--I wanted to contact you personally but can't find where I can do that. Is there an e-mail address at which I can reach you? If so, please e-mail me at jacquelineho88@gmail.com. Thank you, and I hope to hear from you soon!

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  3. I also danced with insurance, doctors and letters. Finally I broke down and ordered a light brush. I have used it but without total success. I will be anxious to read an update on your review of your situation. Good luck!

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  4. Nice article. I've thru a lot of medication with psoriasin and the only everlasting cure for me is strength and will. please visit http://goo.gl/eaqSCu

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