We Are Deep In the Heart of Texas

Nomadic seasons of farming adventures with nature thrown in to include; a pinch of family, snippets of friends, counting our blessings, paying IT forward, home school, and the spicy things I decide to rant about.







Tuesday, February 23, 2010

FSAFEDS Diatribe

As you all know, I wrote on here about the FSAFEDS.  To vent over the frustration of not being reimbursed for legitimate medical items we have purchased on the advice of a licensed by the state of Texas allergy specialist.  LOL

So, I was contacted by Carol via telephone last week, who said she would look into our submissions that was on Thursday. This is the kicker.  I have around $400 in other claims awaiting processing because 

WELL

We can't seem to get someone to approve the items as instructed to us by our family specialist for our son Saenz.

AND THEN, I GET ANOTHER CANNED EMAIL:

"On Fri, Feb 19, 2010 at 12:15 PM, FSAFEDS wrote:


Dear Mrs. Malissa Torres,

Thank you for your email about your right to appeal a denied FSAFEDS claim.

To submit an appeal, you must write to FSAFEDS and request a review. Include any additional information and/or documentation, such as a Letter of Medical Necessity, that supports the reason(s) you feel your claim should be eligible for reimbursement. To obtain a Quick Reference Guide regarding the Appeal Process, please visit our web site www.FSAFEDS.com. This guide can be accessed under the Quick Links section, by selecting the Quick Reference Guide link. Submit all written appeals by:  Fax: 502-267-2233 or 866-643-2245 for those outside the U.S.  OR  Mail:   FSAFEDS  P.O. Box 36880 Louisville, KY 40233

If you need further assistance or have additional questions, please feel free to contact us again via email at FSAFEDS@shps.com, or call an FSAFEDS Benefits Counselor toll-free at 1-877-FSAFEDS (372-3337), TTY: 1-800-952-0450, Monday through Friday, 9:00 a.m. until 9:00 p.m. Eastern Time.


Thank you,
FSAFEDS"

YES, I SEEN THIS ABOVE EMAIL ON SATURDAY

I had to give myself some cooling off time before replying.

My answer back to the 'canned email.'

"To FSAFEDS,

First, This email with your company's response above inquiry will be added to my blogspot.

I was contacted by an employee last week, named Carol.

She informed me, that as a supervisor she would be reviewing our submissions.

We have included:  A. Doctors explanation or Letter of Medical Necessity (not on required form).   B. A letter explaining my son's treatment for his allergies to include the purchase of: 
allergen specific bed products such as: mattress/box spring covers, pillow covers

Eucerin skin products to alleviate his skin allergies as a result of his nasal or environmental allergies

Special Allergen Reducing air conditioning filters

C. A form as required to show the doctors licensure information to include contact information.

Secondly, again my question is this computer generated email is too vague in reference and to which submission is the FSAFeds referring to -- considering the number of submissions we have already forwarded. What did Carol find out?

Did she contact the Allergy Specialist for any further information?

I am trying very hard to retain my civility and professional decorum however, this faceless / voiceless mode of communication is quite frustrating. All I want to know is exactly what information is missing? WHY are our claims being denied? We are not being given any sound professional assessments as to what on our end; what we are not doing correctly to further facilitate these claims.
Respectfully, M Torres on behalf of Mr G. Torres"

Mind you, now my husband is so disgusted by this round and round with this governmental agency that, we went to buy a fax machine for use just with FSAFEDS.  Just to deal with sending in our forms, over and over to include our begging of them to reconsider their opines.  He is tired of going to another office to fax information to FSAFEDS only to have it lost or denied.  Can't say that I blame him. 

So my title with use of DIATRIBE equates to their wearing us down and prolonging the claims process.  Is it any wonder 80% of Americans feel their government acts without citizens' best interest in mind?

Last blog rant dealing with this subject found here:

http://saenzmom.blogspot.com/2010/02/i-got-bit-terse-with-fsafeds-via-email.html

10 comments:

Jack & Jill said...

Think they are waiting for you to give up. I believe they do this as a matter of policy. Sorry to hear they are giving you such a hard time.

Nekkid Chicken said...

ROLLS OVER HERE

You know besides being able to kiss my own hind parts.

I think you are right and will just muddle along as well.

How are you Miss?

Chicken Boys said...

That's the government for you. You have my sympathy. I used to live in South Texas. I lived in Beeville between Corpus and San Antonio. I was driving a truck at the time out of Laredo.
~Randy

Texan said...

Bingo wearing you down and getting you to give in!

Different type problem, same area of issue medical ... two years we dealt with accounting issues of which none were ours over a MRI bill! Two years they tried and tried to squeeze more money from us! Finally resolved it and wow amazing we didn't owe the money that we tried to tell them we didn't owe per our EOB and everything else we could come up with!! But two years of total annoying crud from them!

Hang in there, don't give in!

Nekkid Chicken said...

Randy, We live outside of Beeville about 22 miles outside. It's where we have to go to shop. Our little slice of heaven is where Oakville used to be; that little township was absorbed by Three Rivers. My son Saenz, goes to school in George West because their special education program was excellent. SMALL WORLD RIGHT? LOL

Thanks for stopping by

Nekkid Chicken said...

Texan,

Thing is, I know the difference between what doctors office charge 'civilians' and what they are paid by the state. So my question is WHY SUCH A BIG DISPARITY? I firmly believe in paying for the service I receive however, I don't want to pay for that I did not recieve? For example, Saenz's MRI charge to insurance was 2900 dollars but, Military Humana only paid then 700. So, where is the real price?

This health care for profit is a horrible system. JMHO

Jack & Jill said...

You can catch up on my ramblings at lifewithjacknjill.blogspot.com I don't know if I have the settings right, if you can't get in let me know. I'm doing okay most days.

About medical charges, I had some blood work done and just one of the blood tests was $1,400+, the insurance got it down to $200+, but if we didn't have insurance, well, let's just say that we would be living in a Charmin box!

kybunker said...

Hey I wonder if that new fax machine is deductible,,, It's being used as a health care service!

Maybe they are coupon clippers too! Looking for a way to save a buck from everyone they can!

You must have the words, Guilble written on your forehead

Well thanks to your blog,, I'm sticking with the insurance we have, was debating on using the same as you, but as for my pocket book,,,, look safer to handle the old fashioned insurance companies.
Thanks Malissa for your wonderful Informing blogs!

Nekkid Chicken said...

Jill,

Send that Charmin box here will ya? Zephyr needs to build a fort according to him; it has to be a rather large box.

LOL Looks like I will have to order something off of Alice.com so, I can comply with his wishes.

Nekkid Chicken said...

Kelley,

Hold on to your fire brand there missy.

Seems, I was getting a 'canned' system response. Our supervisor Carol, got back with me from the FSAFEDS and worked the 'potential' issues with her supervisors, we are going to get reimbursed as of Gil's next check. Hopefully,

Feathers Crossed

I will put up a blog to you explaining the FSAFEDS system.