New Stoma
Comments
-
Yo..
You didn't say if you need help, but if you do... Just ask.
I have had an Ileostomy since 2006.
I had an operation last January/February that left me in roughly
the shape you're in. I now have two stomas to maintain.
One is the new Ileostomy, and the other one is still connected
to an unknown amount of intestine. It would normally be called
a "mucous fistula", but the output fills a mini urostomy pouch.
The primary insurance company (medicare) does not pay for
pouching for a mucous fistula, even though a pouching system
is required due to the enormous output.
The secondary insurance (BC/BS) uses Medicare as a filter,
and if it isn't covered by Medicare, BC/BS denies the claim.
I now have two Ileostomies.... Stoma one, and stoma two.
If you need help, just ask.
Best of health to you,
John0 -
insuranceJohn23 said:Yo..
You didn't say if you need help, but if you do... Just ask.
I have had an Ileostomy since 2006.
I had an operation last January/February that left me in roughly
the shape you're in. I now have two stomas to maintain.
One is the new Ileostomy, and the other one is still connected
to an unknown amount of intestine. It would normally be called
a "mucous fistula", but the output fills a mini urostomy pouch.
The primary insurance company (medicare) does not pay for
pouching for a mucous fistula, even though a pouching system
is required due to the enormous output.
The secondary insurance (BC/BS) uses Medicare as a filter,
and if it isn't covered by Medicare, BC/BS denies the claim.
I now have two Ileostomies.... Stoma one, and stoma two.
If you need help, just ask.
Best of health to you,
John
How the hekk/hell can insurance companies get away with that??!!
You have TWO (2) ileostomies and thay can deny maintaining them?!
WTF
mark0 -
Mark -marqimark said:insurance
How the hekk/hell can insurance companies get away with that??!!
You have TWO (2) ileostomies and thay can deny maintaining them?!
WTF
mark
It's not that they're leaving me high and wet, but there isn't any such thing
as having two of the same ostomy; it just doesn't make sense to claim two.
You can have a urostomy, and a colostomy or ileostomy, or any combination
of the three, but two can't be the same.
I can't claim the old ileostomy is anything but either an ileostomy, or what
is described as a "mucous fistula". Neither fits the exact nature of it, so
I am at the mercy of the system. The GP thinks she may have convinced them
that it is ileostomy1 and ileostomy2. I guess I'll find out when I put the order in!
I'm thankful that I have supplies saved up (as anyone with an ostomy should have),
and probably enough for a year. I'll have to toss an order in to see what happens.
Medicare rejected it the last time, and BC/BS uses medicare as a filter. So if
it's denied, that's the end of it. If it's OK'd, but not paid for, BC/BS pays.
Ain't life grand, Mark?
Stay well,
John0 -
IJohn23 said:Mark -
It's not that they're leaving me high and wet, but there isn't any such thing
as having two of the same ostomy; it just doesn't make sense to claim two.
You can have a urostomy, and a colostomy or ileostomy, or any combination
of the three, but two can't be the same.
I can't claim the old ileostomy is anything but either an ileostomy, or what
is described as a "mucous fistula". Neither fits the exact nature of it, so
I am at the mercy of the system. The GP thinks she may have convinced them
that it is ileostomy1 and ileostomy2. I guess I'll find out when I put the order in!
I'm thankful that I have supplies saved up (as anyone with an ostomy should have),
and probably enough for a year. I'll have to toss an order in to see what happens.
Medicare rejected it the last time, and BC/BS uses medicare as a filter. So if
it's denied, that's the end of it. If it's OK'd, but not paid for, BC/BS pays.
Ain't life grand, Mark?
Stay well,
John
Well, I think if you, employer, or STATE pays to cover your health issues ( I dony know who BC/BS (bull $hit) is) they should cover your needs!,../? (>_<)
Mark0 -
Thank you John I also haveJohn23 said:Yo..
You didn't say if you need help, but if you do... Just ask.
I have had an Ileostomy since 2006.
I had an operation last January/February that left me in roughly
the shape you're in. I now have two stomas to maintain.
One is the new Ileostomy, and the other one is still connected
to an unknown amount of intestine. It would normally be called
a "mucous fistula", but the output fills a mini urostomy pouch.
The primary insurance company (medicare) does not pay for
pouching for a mucous fistula, even though a pouching system
is required due to the enormous output.
The secondary insurance (BC/BS) uses Medicare as a filter,
and if it isn't covered by Medicare, BC/BS denies the claim.
I now have two Ileostomies.... Stoma one, and stoma two.
If you need help, just ask.
Best of health to you,
John
Thank you John I also have the 2 but mine is drying up now just need a bandage on it
if your DR say's you need 2 bags they have to give it to you. What state do you live in?0 -
qwe -qwe said:Thank you John I also have
Thank you John I also have the 2 but mine is drying up now just need a bandage on it
if your DR say's you need 2 bags they have to give it to you. What state do you live in?
I'm in Florida, but Medicare's guidelines are universal.
They need proper coding for their computers, and a computer
won't digest having two of the same ostomy.
Medicare -will not- pay for a pouching system for a mucous fistula,
and that is essentially what the old ileostomy can be described as.
But a mucous fistula only expels a small amount of mucous,
and a simple band-aid can be used to contain the output.
My output for that old stoma, is between 1-4oz per 3-4 hr period;
sometimes more, sometimes less....
If cancer doesn't get you, it's ramifications will.
Best wishes,
John0
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