IUD impasse with Capital Women's Care - is this run-around common or just me?

[Anonymous]

I second the recommendation for Reiter & Hill. I see Sharon Frisch and really like her.

[Anonymous]

Of all the medical offices we've used as a family, our experiences with Birthcare have been the easiest and least stress-free. I suspect they have some kind of insurance guru on staff and whoever she is, they are not paying her enough.

[Anonymous]

It's a him. I suspect you're right.

[Anonymous]

Anonymous wrote:

Anonymous wrote:This is an insurance problem. BCBS is screwing the MDs by not reimbursing them the cost of the device. That is why they make you order it. But, CWC is also being really unhelpful. They should at least give you the option of paying up front and getting reimbursed (though that is a hassle for them too).

If you work for the feds, complain and maybe the policy can get fixed in the next open season.

I'm an OB and this is exactly what is happening. I'd love to offer my patients the Mirena but I loose money on every one i insert. Literally, i pay $$ out of my pocket.

I'm a Pharma Rep and I can agree with the PP and the OB that this is what is happening.

To the OB: discuss this w/your Mirena rep the next time he/she comes in ... or have your billing staff discuss. You need to make sure the proper billing codes are being used and that the pre-auths are being submitted prior to the date of insertion. If your billing coordinator does it properly you should have no problems getting it covered.

Hope that helps.

[Anonymous]

My midwife actually got my IUD from Birthcare to insert for me. I have BCBS too and she had originally asked me to get it from the pharmacy as you stated but in the end I submitted the whole thing as out of pocket/out of network provider and at least got my 70% covered.

[Anonymous]

This same thing happened to me. I had mine inserted about a year ago by a different CWC office. I remember telling both the office and the insurance company the same thing... I am not sure which one did it, but someone finally called the other person and worked it out. It was at my doctor's office for my appointment. Call the front office of the CWC your troubles... I would ask to speak to the person in charge

[Anonymous]

question- I am planning on getting a paraguard with CWC. Was this problem only for the Mirena or also for the Paraguard?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This is an insurance problem. BCBS is screwing the MDs by not reimbursing them the cost of the device. That is why they make you order it. But, CWC is also being really unhelpful. They should at least give you the option of paying up front and getting reimbursed (though that is a hassle for them too).

If you work for the feds, complain and maybe the policy can get fixed in the next open season.

I'm an OB and this is exactly what is happening. I'd love to offer my patients the Mirena but I loose money on every one i insert. Literally, i pay $$ out of my pocket.

I'm a Pharma Rep and I can agree with the PP and the OB that this is what is happening.

To the OB: discuss this w/your Mirena rep the next time he/she comes in ... or have your billing staff discuss. You need to make sure the proper billing codes are being used and that the pre-auths are being submitted prior to the date of insertion. If your billing coordinator does it properly you should have no problems getting it covered.

Hope that helps.

This may show how little I know about insurance billing. But, to the doctor, can't you just bill the patient for the cost of the IUD so you are not losing money?