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Woman wins insurance battle for wheelchair feature

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  • Woman wins insurance battle for wheelchair feature

    Quadriplegic Raleigh woman wins insurance battle for wheelchair, now fights for change

    Ali Ingersoll is paralyzed from the chest down after a diving accident in 2010. She has limited mobility in her hands and uses a powered wheelchair.

    For years, Ingersoll told The News & Observer, this has meant working and struggling with insurance to get the equipment she needs to live.

    Ingersoll, a financial day trader, uses Blue Cross Blue Shield of North Carolina as it is one of the few left in the state that still offer policies under the Affordable Care Act.

    Read more here:

    https://www.newsobserver.com/news/lo...DCu1Si7C8h8__Y qrkCjXhaS4PaBFy_Oi8DO0thBM1o5-eONFYTO-NI#storylink=cpy


    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  • #2
    That's a great article. I hope it inspires more folks to be tenacious in their own advocacy. It really makes a difference.

    I'm gonna pick a bone with one small part of it though:

    "Alan T. Brown from the Christopher and Dana Reeve Foundation, a quadriplegic since 1988, told The N&O that this issue is common for people with disabilities.

    “Insurance companies don’t realize the healthier they keep us and give us what we need to function, the less they’re going to need to give us in the future,” he said."

    They very much realize it. I ran an IT department of data professionals dedicated to supporting a business department of actuarial professionals dedicated to the statistical understanding of where to draw the lines between when to "pay now" vs the risks of having to "pay more" later. My protege is actually the Director of Decision Support at BCBS of NC today. She very much knows what this gentleman suggests insurance companies "don't realize". That's literally her job.

    The moral of the story is very real, though: as hard and as tedious as it can be, if you're certain there is a medical basis for something that has been denied, don't give up on yourself. There are other departments literally focused on simply where to cut losses and just say, "Yes." to someone making too much noise and occupying too much of their effort.

    Consistent Advocacy is the key!
    "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

    "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

    Comment


    • Oddity
      Oddity commented
      Editing a comment
      I mention this just so folks don't go into advocacy thinking insurance companies are 'dumb' and just need to be 'educated' about simple things that profoundly affect their bottom lines, then they'd cover everything. It's just not like that at all.

  • #3
    So true, Oddity! Most people don't realize that insurance companies make a profit for their investors by DENYING care. They are set up to do that from the get-go. Most claims are processed by a clerk who is just blinding going by a manual that gives the company's justification of denials, and a very warped philosophy of what is "medically necessary".

    Most people do not know that these denials can be appealed, and that you can request a review of the denial by an actual physician specialist. Most people just take the denial and go no further.

    I am actively working with a number of organizations to get universal, single payor health care for all residents, both in CA and for the entire USA. Health "insurance" companies will no longer exist, and can change over to selling ridiculous life insurance, "accident", and "cancer" insurance policies to fleece the America public, but keep their hands out of telling me and anyone else what we can do with our bodies and for our health.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

    Comment


    • #4
      Good for Ali, currently battling BCBS to get titanium rather than aluminum. It's ridiculous, am a state employee, myself and employer combined pay a fortune for this plan.

      Comment

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