well, i finally got my doctor to take appropriate tests. the results are in and i have high levels of testostorone and my insulin levels are way high. i was refered to and endocrinologist which i have an appt. w/ them in late may. Finally i am on the right path and doctors are finally giving me the answers where i can make changes. I’m not sure what exactly the endo. doctor will do, i suppose look at my lab results and perscribe meds. hopefully help me in the right direction to getting rid of this hair. it feels good to finally get answers.
I am glad that you finally got some help from your medical team to put you on the road to hair free and care free. I hope that others who can trace your story here find inspiration on how to deal with this kind of thing. Without the information you finally have, and the treatment of the systemic problem you present with, the only thing an electrologist could do for you would be to remove the hairs that are there, and try to keep up with the new ones you would no doubt be growing in the future. Until you would present and get every hair treated, you would have a lifetime of treatments ahead of you, and you would no doubt think that electrolysis does not work, or stimulates growth. At least now, you will have the hair problem stopped so the hair that you already have can be removed without worries for new hairs coming in.
If you are ready for another hard fight, you can get your insurance company to pay for your electrolysis treatments if your doctor will co-operate in letter writing for payment for treatment of all your conditions side effects.
yes James, i’m ready for that hard fight as well. why quit when i’m ahead, right! One question on that would be, should i get that letter from 1. my primary care doc. 2. my ob/gyn or 3. my Endocrinologist. (or all 3). And of course the letter should explain that electrology will be a perscription to treat hirtuism (sorry for spelling). correct? no?
You have the idea.
If you can swing it, get all of your doctors to prescribe electrolysis. It should also be noted that the hair removal is not only a treatment for hirsutism, but that it is an integral part of both your medical team’s diagnostic and treatment plan. It is impossible to know if the medication to arrest your systemic problems are working without removing the previously grown hair.
Remember to keep all originals (have your doctor create two originals, one sent to you, and the other to the insurance company) and send everything certified mail, so someone has to sign for it, and you get a return receipt for each item you mail
They will try to say that they never got anything you sent, or that it was lost in the office, or some such nonsense. If you are always able to produce another copy, they will have to change stall tactics.
Later, when you are suing them, you will have proof of your compliance with their notifications and their stall tactics.
It won’t be easy, but it will be worth it.
thanks James…i appreciate your help as many of us do on this board. In the future, if i have any more questions or concerns, i hope you don’t mind helping me out! I know it will not be easy, nothing has been from dealing to treating this syndrome (or whatever you call it)…but i’ve lasted this long and I’m in no way ready to quit! I will, of couse, post my progress and any referrals that i have.
to update everyone. i’ve finally have a diagnosis from my endo doc. i have PCOS. tests are still being taking (ultrasound of ovaries and 24 hour urine test) and i’m now taking glucophage (spelling could be wrong). Well, now that i have a diagnosis and am taking medication, I can start looking upwards out of this hole i am in, and start digging my way out. i recently found out that my aunt and cousin went to an electrologist and were extremely happy with her. now i have to obtain my letters from my doctors and start with the hair removal. any referrals i get will, in time, be put in the referral part of this board. i just want to thank this board and the people on it. if it wasn’t for this place, i’d probably still be at square one. thanks all…i’ll keep updating as things look forward!
[ June 02, 2004, 11:05 AM: Message edited by: babyblue ]
Just a little something for those who either don’t belive that Insurance pays for this treatment, or that it has to be hard if they do, here is a conversation between two electrologists recently, from another board.
I hope it helps those of you thinking about this insurance payment situation.
Hope that someone can help me with this!
I have a question that needs to be addressed and I am sure that this situation will become more prevalent in the future.
I have a client with PCOS, who has petitioned her health insurance for coverage of electrolysis treatments. She does have a letter from her OBGYN stating that electrolysis treatments are nessessary for a hirsute problem due to the PCOS. She has been given approval for the treatments.
I have never dealt with an insurance company in this manner and would like to know if someone has and what should I expect. Are there any speacial forms that I should have or get from this client? Do I ask for payment up front and have her get reimbursed herself?
Any help would be greatly appreciated!!
I dealt with this several years ago when there were third party payments.
At that time I did get paid and requested the insurance company send the check to the client. If they sent it to me in error I signed it over to them
I don’t know if they work the same today
Thank You for writing back. I just found out today that the insurance company will be paying me directly. The insurance company gave me an authorization number for her treatments. They have approved my client for treatments for the next to two months then I will reevaluate and submit another request for more appointments. I was very up front about not being able to give a set amount of appointments, when dealing with a case of PCOS. They didn’t have a problem with it. I must say that it really wasn’t as bad as I thought it would be.
There are a lot of women out there that would come if they were covered by their insurance company. I have a second client who I had go to her OBGYN this week also to request treatment. If there is a diagnosis of PCOS, there should be no question what so ever about electrolysis treatments. I think the insurance companys would rather pay us then someone who is doing laser. Besides, we have 129 years standing behind us, that should stand for something!
Thanks - that is an interesting post. I have been told by WAAAAY too many people that insurance will not cover the treatments … even with a prescription … I think when i finally find a good doctor I’ll see if they’ll write me a prescription/letter.
Let’s say my insurance will pay if I get a letter … ok … I saw an endo yrs ago and was never actually diagnosed, but I have had some tests that concluded I had high testosterone … the glucose tests appeared normal, my weight is fairly normal, as is my menstration … none of it is perfect of course, but I have a slew of problems … extreme excess of dark, course hair where women aren’t supposed to have it, acne, shaking … my hands especially shake terribly … I’m not really thin, but Im not huge … I eat healthfully for the most part, but I don’t get as much exercise as I would like … one of my eyelids is droopy, think I have asthma or chronic bronchitis/possibly food allergies I need to also get check out for … anwyay about insurance … I was never diagnosed with a problem, but since then I have gotten a new job with health benefits. I was on the same type of insurance under my parents’ … will they say it is a preexisting condition and deny me electrolysis or other health coverage now that I am under my own insurance.
It is always the insurance company’s way to tell you anything they can to discourage you and hope you go away.
Of course, since you never were officially diagnosed with anything in particular, how could it be a “preexisting condition”?
In my opinion, what you need is a medical team that works with you to make this happen, and either an insurance company that rolls over, or the fire to make them pay in the end.
Some companies don’t sweat you this too much. I wonder if they have just had too many other people sue them and are tired of the court costs.
Some people have said that they got no guff from their company from the start… but those people came to the table with a diagnosis, and a letter written by their doctor.
So far, I have been to many electrolysis appts. to add up to almost $1,500. I have a completed claims form for my particular insurance company, a letter from my endocrinologist and a receipt from every appt. I had with my electrolysis. I have made copies of all of this for my records and am going to send it out by certified mail. Then after I mail it out, I cross my fingers and hope they don’t give me a hard time. If they don’t, great. If they do, I will raise as much hell as I can to get reimbursed. I am not getting electrolysis done for a cosmetic reason…It IS a medical condition! Thanks James for all your help, and I will keep you all updated with the results. Good luck to all who is going through what i am, it’s an uphill battle!
Congratulations, you are now in the price range where you can file a small claims case. Find out what the legal limits are in your area. Some places limit small claims to $3,000.00 some to $5,000.00
However, for your purposes, filing a case sooner could pave the way for better treatment from the insurance company later. While you can bring all the stuff you have and a copy of your policy and argue your case, they MUST send a lawyer, not just an employee of the firm. Don’t accept a mediator, take trial by jury if it is available, and a judge if jury is not an option. Do not accept a law clerk, only a judge!
They can’t win the case if it is fair. Then, they know that you will just do the same thing every year if they don’t honor your treatment claims.
Well, this company is a toss up. It’s Blue Cross Blue Shield. They do get ways around things … when they’re good they’re good. When they’re bad they’re oh so bad. I have been told that they’re notorious for not paying for ‘cosmetic’ procedures … or for payigng less than most places. I know this is not a cosmetic thing and that people win cases with other companies. Do they understand how much this type of thing affects people? … especially girls that get it when they’re young like I did … I mean … I have heard 12-yr-old girls that literally wanted to commit suicide and things because they didn’t want to go through life having to deal with it … that’s aggravating a possible mental illness like depression … having to wait for that one in a million guy that doesn’t care … or having to plain vacations, sleepovers, campouts and such around their extra hair, not to mention all the other associated problems. I mean sometimes I have read forums like this … and I just wanted to cry at some of the things girls said because I know what they’re going through and how usually (even though it is a common problem in older women) when you’re young, you’re almost always the only girl that you know with the problem … you’re the only one whose parents think it’s not important and you’re being vain … you’re the only one that everybody makes fun or (even family members) … yeah it’s rough, especially for the ones of s that have had other stresses in our life … like abuse and things. I mean there are even guys that get upset about too much hair and it’s not even as much of a social stigma for them. There oughtta be automatic medical treatment … not all the hassle.
ok…i’ve submitted everything and just have a quick question! i sent it certified mail on jan 20th, and received the receipt stating it was received on jan. 29th. now, it being feb. 20th, how long should i wait for a response until contacting my insurance company. or, should i just go ahead and file an appeal (even without getting a “no” from the insurance co.). hope this makes sense. thanks!
Actually, you make lots of sense.
If I were you, I would already call them to ask about the status of the claim. Make sure you get the names of everyone you speak to. Better yet, tape record the call. After all, their phone greeting says that the call will be recorded for quality assurance purposes, so they have already consented to having the call recorded. <img src="/ubbthreads/images/graemlins/tongue.gif" alt="" />
I would also be putting together my appeal for filing on the 20th business day (about 30 days)after they got your mail. I would also be all ready with the small claims forms to file 60 business days (about 90 days) after they got your mail, assuming they ignore you.
If nothing else, they will see that they can’t put you off so easily, and you won’t be ignored.
thanks so much for your help James…i really, really appreciate this!! <img src="/ubbthreads/images/graemlins/smile.gif" alt="" />
well…i’ve been denied my claim…which i was expecting. I am in the process of the appeal and once i get denied that, i go for an external review. I feel somewhat confident of the exteranl review, but do not know who actually reviews the claim. With all my receipts, letter from my endo and my persisitance, I hope they see that this is not cosmetic. we shall see!
Now don’t you feel better about all this, because you knew what to expect? You know the path. You know that at the end of the tunnel is your money. Most people would have given up by now. They are surprized you persisted this far.
Keep us informed.
Ask your doctor he/she is willing to testify on your behalf when the time comes.
Just trying to keep all the information on this subject linked. Here is a link to more insurance information.
ok…i’ve come to my final denied appeal. now is time for action. i am getting discouraged a bit, but i know that is what they were hoping for. my final letter from my insur. co. states that under my insurance plan described under my employers rules that this is not cover and considered cosmetic. in my previous letter to the insurance co. i stated that in order to tell the meds are working correctly, i must undergo electrolysis to rid existing hairs and ensure that no new hairs are growing. they stated in the letter of denial that my reasoning for electrolysis is because of the meds. from what i read and understood from the letter, they make it sound like i’m requesting this claim because the meds i took caused hair to grow…and that is not the case at all. they don’t even understand the reasoning. i’m very pissed and very discouraged…and i’m trying to get the energy to pursue this. oh sigh!!