WC denied my meds after release from hospital

[bodybuilder1958]

Hi All,

I had contacted my lawyer over a week ago to request that he contact respondent about making sure my WC prescription card was activated.
Saturday after leaving the hospital we headed to Walgreens to get my prescriptions filled. WC would not pay for the prescriptions. When my husband talked to them he was told that there had been no activity on my card in over a yr and a half and that my claim may not be legitimate.
So we had to pay for my meds in cash. The cost, $99.97.

A hundred dollars, what would of happened if we didn't have $100. to pay for them? This is the second time in a row after surgery that WC initially denied paying for my medication. Luckily that time the cost was low the next morning Walgreens called saying that they had gotten authorization.

I hate this system, I try not to hate but for WC I will make an exception. You think you have all of your bases covered but they always find a way to make you miserable.

Bodybuilder1958

[jayne]

I am sorry BB but glad you had the 100 dollars many in WC dont.....hope you feel better soon

[Bummer Knees]

I never ran my meds thru work comp, always use my health insurance.
Course with as picky as I am with my meds......I only take a few.

I just did not want the headache of work comp involved in another part of my life.

[freebird]

(05-02-2011 12:13 PM)Bummer Knees Wrote:  I never ran my meds thru work comp, always use my health insurance.
Course with as picky as I am with my meds......I only take a few.

I just did not want the headache of work comp involved in another part of my life.

If you were on a active WC Claim at the time you filled your meds, I am surprised your Health Insurance paid for it OR Have not seeked reimbursement.

WC has paid for all my prescription meds for almost 8 years that have to do with my work related Injury.

I have a lot of information concerning procedures for WC and GHP and Medicare....

[Bummer Knees]

freebird, I have never had a problem with the insurance company paying for my prescriptions.

I would not recomend others doing what I did, all the copays are expensive, my last trip to the pharmacy co-pays were $200.00 I just did not want to wait around for work comp to play their games with my meds.

[freebird]

(05-02-2011 05:06 PM)Bummer Knees Wrote:  freebird, I have never had a problem with the insurance company paying for my prescriptions.

I would not recomend others doing what I did, all the copays are expensive, my last trip to the pharmacy co-pays were $200.00 I just did not want to wait around for work comp to play their games with my meds.

My GHP addressed the possibilty of being reimbursed IF I had used Express Scripts for any medications related to my work injury as did Medicare. All this took place when a MSA was prepared.

I had not used express scripts or Medicare for my work related injury Thank God or the red tape would have been pulled out.

I just want to clarify this so a IW will not be mislead. All cases are different but your situation is unusual.

[Cervical_Fusion]

I am right now dealing with WC not payinbg for 3 of my meds, Some of the 3 they have been paying for was on my claim for 10 years now. I went to wc hearing on them before and they were told to pay but here are the games again,

[bodybuilder1958]

We called the WC prescription card company this morning and they said that my card had been re-activated and I should be able to get a full refund from Walgreens. Went to Walgreens, yes they had authorized the drugs but they hadn't been paid. So I had to wait 45 minutes while the pharmacist called the company and then waited for for the payment to Walgreens to go thru.

So eventually we did get my refund, all $99.84.

I went to the hospital for my post-op labs, we had to wait for authorization from WC for those labs. Stupid, just stupid.

[jayne]

could you send WC a bill for your time?

[sonny1]

They make life unbearable most times. The WC insurance company I have to deal with uses a 3rd party prescription company. So when I drop off WC script it goes to 3rd party 1st, sometimes it goes right through others comes back saying needs prior authorization. So attorney has to get a hold of the adjuster and let them know what is going on. Adjuster has to "evaluate" script and determine if ok. Then adjuster is "supposed to "contact" 3rd party and authorize it. attorney calls me to say all good adjuster ok it....yea right, I know the game, she verbally ok it to you, but did not fax the ok to 3rd party, who has to enter ok in the computer from fax. So when all is said and done about 14 phone calls and 3-4 days wasted!!! Imagine, these people get paid to torture us...