Treatment or family: how to avoid this medical decision

Let me introduce Cari; a teacher, a loving wife and the mother of two young children who have recently been diagnosed with Crohn's disease and prescription infusion. Cari assumes that her insurance policy covers these treatments until she receives a bill close to $20,000, which is a treatment. She must continue these treatments every five weeks!!!!! After much success, Cari reached out to me in horror, and we managed to reduce her bill to $411 and provide some tips:

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Enter your Zen from

 The last thing that Cari needs is ulceration. Through several deep breaths and action plans, she is ready to solve this "billing monster."

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Get a copy of the itemized list and medical records from

 : We can remember some billing errors, but we can clearly understand what is being done and whether there are any options. In Cari's place, it seems that her insurance refused some of the bills because the infusion center was not covered by her insurance.

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Talk to the right person: from

 Some facilities have patient advocates or social workers who can help find other payment methods. Cari was able to verify what we found through the facility's advocates. In addition, the advocates pointed out that Cari was eligible for some additional insurance options, but did not use it, so we immediately filled out all the paperwork with the help of the facility and asked her to make the right plan within 2 months.

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Talk to your prescription doctor: from

 Maybe there is alternative medicine or a cheaper treatment? In Cari's case, she has an adverse reaction to alternative therapies, so this is not an option. In some cases, the prescriber may provide a free sample [usually about 2 months] that he/she can provide for you without having to calculate a financial solution. Cari's case is a bit more difficult because she needs a biological agent, which is often a slightly more complicated treatment because it involves many factors, including the infusion site.

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Find out which financial assistance programs: from

 There are many "Patience Assistance Programs" and/or "Financial Demand Plans" available for all situations. Become familiar with these procedures and get qualified as soon as possible. Some potentially useful sites include: NeedyMeds, Rx Access or State Drug Assistance Programs.

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Go directly to the manufacturer: from

 Many large manufacturers have an Access Service Manager or similar person who can guide you through the qualification process for certain access and affordability programs. Cari found Kim, she is the access service manager for Remicade, and she went to Janssen Pharmaceuticals, Inc. The website also dialed the 888 number. For those who are less savvy, the prescribing doctor can help you provide the correct number by contacting their representative who is dealing with the pharmaceutical company.

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Pleasant and ready: from

 Before making any calls, take a deep breath and make sure to write down the following information so that it is provided in a consistent manner when requested by the delegate, which will make the call enjoyable and fast:

• Your name and contact details
• Drug prescription
• Required location if needed
• Insurance information [if you have insurance]
• Your income level [your W-2 copy can provide this information]

Some programs may require additional information and you may not be able to get the right person by phone the first time. Be patient and persevere. If your blood starts to boil, hang up when you are calm, or call your loved ones.

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Take notes: from

 If possible, please get the person's name and contact information. Record the date and time of the call and summarize what is said, including any other instructions given to you and when the person can call you back. In Cari's case, we were asked to call back to get the latest information about what Kim could find about her situation. In short, Kim was able to find a website that covered her insurance and determined that the site was accepting new patients. Kim also provided additional free services to Cari to remind her of the date of injection.

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Breathe and start: from

 Everything is now verified, and Cari can get her injection without going into medical debt. In addition, she knows that she needs a breakdown of the sub-item and her medical records after each infusion so she can track her bills and make sure there are no errors. If there is a difference, she will let her access service manager Kim help her solve the problem and avoid ulcers.

Today, Cary is a Empowering person There is no medical debt and an infusion center that facilitates her house, underwritten by her insurance.

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