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Strategies & Market Trends : Take the Money and Run
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To: Peach who wrote (11574)7/30/2002 12:40:51 PM
From: Augustus Gloop  Read Replies (1) of 17639
 
Fellow Friends,

Thanks for your support and concern. Physicians Plus Insurance Group is the name of my HMO. They will not pay for a colonoscopy (as it stands right now) that is outside of the provider list. The problem is this

1) The soonest Physicians Plus could get me in to do a colonoscopy is in September which would preclude me from being in a study that has had a 90% remission rate for people with chrons

I would be more than happy to have my Physicians Plus Doctors do the procedure but they can't do it until September. My feeling is that either way they end up paying for a procedure. The only difference is who they pay to do it. If they allow it to be done at University of Iowa there is a chance that I may be one of the 90% that goes into remission. They are being penny wise and pound foolish. If They don't say yes we're going in front of the Medical Review board and I like my chances vs. an HMO.

In any event - I can't disclose my name to everyone on SI!! For those of you who know it.....feel free to use it. But - that wont matter because they know who I am. The number is 608-282-8900 and then Select Member services. I think the way to approach this is maybe by saying you are an employer who uses P Plus now but that will soon change if they don't allow my to have the scope done in Iowa (if you have a better line or idea - use it!). Tim is the person I talked to and he clearly shielded me from getting back to the review people.

Thanks folks

Gloop
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