Thursday, January 5, 2012

"NYT Reports Risks of DePuy’s Recall Compensation Program?"

Oh NO..Amazing how  how things get taken out of context?

... The subject of this recent  article that has been commented on  from the NY times was about the high cost of the hip replacement. It was not about how the whole Depuy/Broadspire program is at risk.....  This is the NY times article:  https://myaccount.nytimes.com/auth/login?URI=http://www.nytimes.com/2011/12/28/business/the-high-cost-of-failing-artificial-hips.html&OQ=Q5fQ72Q3dQ33

I continue to speak highly of the only part of the Depuy/Broadspire reimbursement program that is available which is that addressing the reimbursement of customary and necessary expenses to replace the hip and treat the problem.  I have never had one problem with this program.  Not one.  I continue to find them to be very responsive to any request I have and have found them to be more than responsible and moral about reimbursing costs.

There have been mistakes and problems in the reimbursement process I am sure, as there might be any reimbursement process  but I didn't see the one case that was provided as a problem in the article that went uncorrected by Broadspire.  It was addressed  and  corrected which the New York Times pointed out.

I think the patients should give the Broadspire and Depuy people a chance to hear their reimbursement concerns and I am quite sure they will be treated fairly for reimbursement of costs if the are reasonable and necessary.  Remember guys, I was completely asymptomatic with strong evidence from  he testing that my hip should be replaced.  I had no problem ever with getting help, feeback immediately and  resolution to any and all questions I have had.

When I was in the hospital, I had my Broadspire rep provide me approval within an hour of my request to be transferred to a rehab unit post surgery.   
Amazing how the Depuy/Broadspire reimbursement question has been  taken completely out of the context...yet again.

10 comments:

  1. Connie, don't be naive, your blog is read all over the world. Do you think Broadspire or DePuy would risk negative comments from one of the largest read blogs in the world. Your blog comes up on first page hits in all major search engines. Come on, your an extremely intelligent gal. You can't use your case as typical. Don't delete this as you have done a bunch of good for folks when they need it. Me included as a bi lateral with major issues after revsion.

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    Replies
    1. Connie-I have been in touch before and have found your blog really helpful.I have also had revision which proved not at all straightforward.I agree with above blog.De Puy are gathering massive amounts of info both medical and otherwise through the payment of expenses.
      I would not doubt for one moment that they are following your blog and know who you are.As other guy said when dealing with you it is in DePuy or their agents interest to be careful how they treat you.

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  2. my medical advantage plan, Wellcare HMO had no orthopaedic specialists who would see me for my 2 recalled hips and DePuy would not pay as I had insurance so for 2 years I had limited medical care for my hips and hi cobalt readings. Has anyone else had this experience?

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  3. To Anonymous above:

    Thanks for your comment.

    Well, I have no idea who does or does not read my blog. I do know that broadspire does not contact Depuy for questions about reimbursement unless it is some unusual request.

    As you may know, each client or Lawyer is assigned and agent at Broadspire. I have gotten to know my agent because as you can well imagine, I have questions about everything. In a recent conversation with my agent (a few weeks ago)I had a question about this reimbursment and sent her to my blog. She had no idea I was writing a blog and am not sure how she would have known that unless I told her.

    Depuy on the other hand is aware of this blog but she doesn't work with Depuy. She has the authority to make payments so long as they are within the reimbursment rules that were set up.

    At some level, yes, Broadspire and Depuy interact but I do believe that Depuy set this claims process up to preserve independence in the reimbursement process.

    As a business person, likely, I would have done the same as arms length claims reimbursment is good for the patient and Depuy.

    I am happy to hear that some of these posts have been helpful to you though and as a fellow patient, I wish you the very best in your recovery.

    Regards,

    Connie

    Anyway, I do appreciate your comment even if I don't particularly agree with it!

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  4. Hi Ralph,

    Thanks for your comment.

    1. Are you working directly with a Broadspire claims agent or are you working thorugh A lawyer?

    2.Are you saying that Wellcare has no orthopedic surgeons? Wellcare has orthopedic surgeons in virtually every market they are in https://encrypted.google.com/#sclient=psy-ab&hl=en&source=hp&q=Wellcare+Orthodpedic+staff&pbx=1&oq=Wellcare+Orthodpedic+staff&aq=f&aqi=&aql=&gs_sm=e&gs_upl=5611l15688l0l16295l37l30l4l0l0l3l938l9102l2-1.3.8.4.2l22l0&bav=on.2,or.r_gc.r_pw.,cf.osb&fp=d6f4b804f9f84a38&biw=1091&bih=462

    Not sure I quite understand the problem?

    REgards,

    Connie

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  5. Hi Connie, I am working by myself as Wellcare says I may only see (in 2010), my original surgeon who is not in their network and 26 Wellcare ortho's refused to see me in 2011.
    I have to pay to see out of network doctors. Broadspire does not pay if one has insurance.
    Do you work for DePuy or Broadspire or a related company?

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  6. Thanks Ralph,

    I have no interest in nor I am I affiliated in any way with Depuy, Broadspire or any affiliate thereof. I am a patient who is facing problems similar to most patients. I started this blog becuause there was void in the information circulated about this condition.

    I think if anything, Depuy would be quite happy if my blog dissapeared off the face of this earth. Why? I am likely the most avid and committed individual based on my research that the long term impact of this Chromium and Cobalt systemically is highly problematic, wellbeyond that which has been discussed thus far. I will continue with my one person mission until something is done to address these issues with funding to primary researchers to uncover these issues.

    I am quite sure my blog is not at the top of thier favorite person list. Quite the contrary.

    Having said all of this, I do look at both sides of the issues. I do feel that the Depuy/Broadspire issues has been blown way out of perportion. I continue to believe that.

    Thanks for answering my question about Wellcare. I am no insurance expert. It seems to me that there are two issues here:

    (1) Well care issue-Were I in your shoes, I would file a claim on this decision (you have to see the original surgeon) to the consumer review office of the Insurance commissioner in your state. They will investigate your claim for no charge. What insurance company would ever claim that you have to see an orginal doctor who treated you if they are out of network. It makes no sense to me.

    The next thing I would do is then call the insurance company to inform them of what you are doing. You would have to call their in house legal counsel's office not customer service. They will look into your claim as well. I have found them to be helpful.

    2. Brodspire- I have no idea what they do when you don't have insurance but that is not the case with you. You seem to have insurance with Wellcare (correct?) but for some odd reason, they want you to see an out of network physcian right?

    Honestly, it shouldn't matter whether the surgeon is in network or out of network because as long as the insurance is in tact, in or out of network billing should be covered by Broadspire. I personally have had consults out of network and they have been reimbursed by Depuy but I have insurance in tact.. In my case I have Blue Cross.

    I am no expert in this area but perhaps I am missing some additional information but just to confirm:

    (1) you are currently insured by Well Care correct?

    You should be entitled to see any orthopod in thier network. they would likely encourge rather than discourge that so this is the point that I don't follow.

    Even if there is some reason you have to go out of network, Broadspire will reimburse your costs. Broadspire should not be discriminating between in and out of network costs.

    2. Have you had an opinion from a surgeon advising that you should revise the hip?

    If so, and you are not in the process of revising, I bet you can find a lawyer to take this case on contingincy.

    Sorry Ralph, I am out of ideas at this point.

    Hope something in this note helps!

    Connie

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  7. Hi Connie,
    Annonymous from above here. It obvious that your a business woman and by your intellect, probably a very successful one. You know that DePuy hired Broadspire and they are micro managing them. Broadspire does everything on behalf of their employer. I think everyone knows how big your reader base is. Google anything about this recall and your blog is always first page. Broadspire or their agents may not let on to knowing who you are but believe me, THEY KNOW. Anyway, keep up the good work. I for one look forward to reading your blog every day as I sit here waiting for an answer.

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  8. thank you for your comment!!

    Lets just agree to disagree but hope that does not discourage you from continuing the blog posts!!

    thanks again.,

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  9. Disagreement is good as it creates multiple paths to what we all desire as an outcome. I thank you for responding to my request for info post revision so fast. If I come across any interesting information, I'll post also.
    Again, thanks Connie, as a fellow Northerner I find it comforting to know that someone cares enough to search for the answers alot of us still having issues pray for.

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