We’re Going to Didney World!
Five months after Dave first started applying his application for reimbursement from the NFL under their Hip Replacement Program and almost 2 months after we first wrote about it back in November, Dave finally received a real check today! (Read about Dave’s Hip Replacement T-Shirt by clicking HERE.)
(Click on images to enlarge for reading.)
Some interesting things of note: The letter is dated Dec. 24th 2008 and the check is dated Jan. 7th 2009. And the check’s actually co-signed by NFL Commissioner Roger Goodell and drawn on a CitiBank account for Non Players Insurance Trust (!). What is the Non Players Insurance Trust? And why are they issuing Dave a check for his hip replacement costs?
The Hip Replacement Program staff had promised to send a check for $195.76 by overnight delivery way back in November. And nothing showed up. Then three different people from the program asked for more documentation of Dave’s paid bills. But there’s absolutely no other documentation or itemization from the NFL that explains how they came up with the extra $312.87 added to the original $195.76 promised back in November.
From what we can figure out so far, it looks like they covered the $300 deductible that Dave had to pay for the surgery itself and then likely a $20.08 co-pay for his walker prior to his discharge from the hospital; the NFL’s Valerie Cross had instructed him to pay them (leaving $1.79 unaccounted for). Then in the last couple of months, he was told that there would be reimbursement for some of his much-needed post-op physical therapy. The NFL’s Mary-Ann Fleming had actually stated that they would likely only approve 6 – 8 sessions (the co-pay’s only $10 a visit anyway!) based on their interpretation of standards in the business. (It turned out there aren’t a set maximum number of treatments according to Dave’s own physical therapy professionals and doctor). Eventually Ms. Fleming said that they’d make an exception and accommodate Dave on his treatment costs. So far, Dave’s had over 30 treatments and submitted copies of all of his out-of-pocket costs to the NFL and it looks like not a single visit’s co-pay has been covered with this check. And absolutely NO prescription costs will be covered at all (probably in keeping with the Commissioner’s No Drug Policy, right?). Wow! Some plan!
In the middle of all this inquiry, they then said that in order to get reimbursement, they needed to have a blanket authorization from Dave allowing them access to his records directly from his doctors and therapists which Dave finally – and reluctantly – signed and submitted as well.
All this for 5 months worth of phone calls, photocopies and time to get reimbursement for a surgery that cost Medicare over $70,000, with three different people over the NFL working on this case to finally cut one check for $517.63. And Dave still has a spine surgery this Spring (none of that is covered by any NFL program) as well as right hip replacement surgery late this year.
Looks like they must have gone back to Gene Upshaw’s old office and dug under all the old seat cushions to find that extra $321.87 (?!!). How else do they come up with this stuff?
