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To: grumpygresh

Can you explain about WPS having a poor reputation among providers?

My husband has had coverage with them for years and is now covered under their Bridge Policy until he hits 65 and Medicare. No provider has ever said a word against WPS and all claims were paid as contracted (minus deductible). They are a State of Wisconsin non-profit and have always been quite reasonable in price while providing many benefits such as no co-pays for office visits, many tests paid for w/no out of pocket and full ER coverage.

He had a major trauma in 2010 and they were a pleasure to deal with. Other than that, he has only needed a check up every 2 years for his BP meds. The clinics he goes to have accepted this insurance without a murmur, while, at one point several years ago, they did seem reluctant to take Golden Rule because “they don’t pay”. That was when we switched.


16 posted on 09/23/2013 3:57:57 PM PDT by reformedliberal
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To: reformedliberal

“Can you explain about WPS having a poor reputation among providers?”

As an interventional pain specialist I can tell you that WPS almost never authorizes pain management procedures; mainstay procedures EVEN COVERED BY MEDICARE AND MEDICAID, such as epidural steroids, radiofrequency, disc procedures in the spine. Every time, these procedures are chacterized as “investigational/experimental”. If you need opiates for debilitating chronic pain, they won’t cover on site urine drug testing which is mandatory if you want to avoid losing your license and DEA#. When we do see a WPS patient for chronic pain, we always tell them that they are self pay.

Hopefully, you won’t have chronic pain, and maybe then, WPS will be great for you. But, it’s estimated (Mayday Fund) that around 70 million Americans have chronic pain.


20 posted on 09/23/2013 4:54:30 PM PDT by grumpygresh (Democrats delenda est. New US economy: Fascism on top, Socialism on the bottom.)
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