They're Baa-aaaack!! (Plus an insurance complaint)

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Posted by Dave W ( on January 19, 2000 at 13:49:37:

Hi Clusterfellers & Clustergals,

Looks like my cycle is here 3 months early this year. I've been in denial (and brutal pain) for the past three days, and will begin dealing with the damn things today... I've been lurking more than posting during my remission these past 5 months, but rest assured you've all been in my prayers!

I found a disturbing reference source today when I picked up my oxygen at the medical supply place. Last year, each time I submitted a receipt to my insurance company for oxygen, they kicked it back because the receipt (which is computer generated) lists my diagnosis as migraine and oxygen is "not indicated therapy for migraines." I then had to write a letter saying what my real diagnosis is, and they had to contact my doctor to verify. Then they paid (3 months later).

I asked today at the store to get the thing changed to say "cluster headaches". They tried their best, but it turns out that there is a universal reference for diagnoses that assigns each disorder a number. In that reference (I think it's called the PDI), cluster headaches are listed as "a variety of migraine" and the software provided with the reference book truncates it to "var. migraine". According to the store insurance expert, all medical insurance companies use the same reference!

I'm personally PO'd that there is a definitive standard out there that calls us migraine-variant-heads instead of clusterheads. With all the recent publicity that our disease has garnered in the last year, I think it's time for them to change. I have the info coming on where to direct my complaint. Wish me luck!

By the way, if anyone has trouble with reimbursement for oxygen, I developed a letter for insurance companies that seems to be pretty effective and I'll be happy to e-mail a copy wherever. I got the citations from a post by either Gary G or Phil or Drummer (I forget which), and I added a little financial analysis that helps them understand why they'd rather pay for oxygen than imitrex if it works.

Thanks for being here -- I better get myself ready for the 2:00 PM head-slammer now.

Goober Dave

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