Contacting ship doctor after cruise

[lilyhammer]

So my son visited the ship doctor while we were on our last cruise and received some medication. I am attempting to get my insurance company to pay for it. According to my travel insurance, I need to go through my primary insurance first and they will cover what it doesn't pay.

 

My primary insurance says that the diagnostic codes used in the statement the ship doctor provided to me are invalid and that they need to correct it and send a new one. I contacted royal caribbean and they told me that royal uses their own diagnostic codes (?!?) and they will not correct it and there is also no way for me to contact the ship doctor. When I asked them what I was supposed to do next, the agent just shrugged "sorry". =(

 

The travel insurance also requires a form for the ship doctor to sign and date. How do I get this completed when I can't contact the ship doctor? Does anybody have any advice/experience about making a claim after a cruise? I feel like they have put up a few impossible hoops and expect me to just go "oh well".

[Clarea]

I should mention that my SO had to be treated on her first cruise (this was when I was still loyal to Carnival) and her regular insurance paid her back with just the most basic medical "receipt" -- but insurers differ. I'm surprised your travel insurance isn't just covering it.

I agree. I'd like to know the name of the travel insurance company so I can avoid it.

[lilyhammer]

It's nationwide cruise travel insurance, choice cruise plan. This is the first time I've used it. They sounded very similar to the typical travelguard or csatravelprotection plans I've used in the past, but had additional cruise benefits (like for missed ports). I don't think it's unusual for travel insurance to want to go through your primary medical insurance first, but this is my first time having any incidents on board.

 

I'm not sure if it's my insurance being a pain or royal caribbean doing it wrong. I'll try your contacts and see if they can help.

 

Thanks!

[cruisenfever]

I agree. I'd like to know the name of the travel insurance company so I can avoid it.

When Jim was treated on board in May of 2014 we got all the necessary paper work from the doctor on board before we disembarked. When I submitted it to CruiseCare, they advised me to submit it to our secondary insurance since Medicare, our primary, would not cover it because we were not within 6 hours of a US Port.

 

Submitted it to our secondary insurance, which is United Health Care, and they refunded us the entire amount spent. CruiseCare did tell us that they would cover any portion that UHC did not, but it wasn't necessary.

 

It's always wise, when being treated on board, to first submit to your primary and then secondary insurance companies.

[fenton04]

If the DGX codes are before 10 1 2015 then yes the DGX code would need to be updated since the new codes are different and no , insurance companies and Medicare will not use the old ones. Good luck!

Edited December 17, 2015 by fenton04

[lilyhammer]

Ah fenton, thanks for your explanation. I was wondering how they could have messed this up. Sounds like this will become an issue for any medical visits after oct 2015. A quick google search came up with some helpful links that I will pass onto royal caribbean to let them know this will be a big issue.

[Enforcer]

Hi,

 

I don't know that this will be of any use to you as I take it that you are from the USA, but in the UK there is legislation which gives you access to medical records. If you don't get any joy with RCI is there any access legislation that may help you from the States.

 

Pete

[dixieva]

We always buy our insurance through Travel Guard. The policy I used to buy required me to first file through my primary insurance (which is Medicare and they do not cover costs incurred on a cruise ship) then file with my Medicare Supplement and then they would cover any balance left. I had to file it with Medicare even though everyone knew they would not cover it- I had to have the denial letter. It was such a pain in the butt. So now I upgraded the policy so that Travel Guard pays any medical bills without me having to file with anyone else. It cost a little more but to me is worth it.

[cruisenfever]

We always buy our insurance through Travel Guard. The policy I used to buy required me to first file through my primary insurance (which is Medicare and they do not cover costs incurred on a cruise ship) then file with my Medicare Supplement and then they would cover any balance left. I had to file it with Medicare even though everyone knew they would not cover it- I had to have the denial letter. It was such a pain in the butt. So now I upgraded the policy so that Travel Guard pays any medical bills without me having to file with anyone else. It cost a little more but to me is worth it.

They will as long as you are at least 6 hours from a US Port.

[Grandma Dazzles]

They will as long as you are at least 6 hours from a US Port.

 

 

Have always been told and understood that Medicare does not cover outside of the US.

[Mjoellnir]

silly insurance companies.. I just pay our trip with my AMEX and they will cover anything that may happen on the trip from I step outside my door and until I come back.

 

But then again, healtcare in Norway is not like in US. We don't need an insurance to get help inside the EU.

[cruisenfever]

cruisenfever]

They will as long as you are at least 6 hours from a US Port.

Have always been told and understood that Medicare does not cover outside of the US.

My response said 6 hours from a US Port. Below is extracted from Medicare Coverage Outside the United States

Will Medicare pay for medically necessary health care services I get on a cruise ship?

Medicare may cover medically necessary health care services you get on a cruise ship in these situations:

•The doctor is allowed under certain laws to provide medical services on the cruise ship.

 

•The ship is in a U.S. port or no more than 6 hours away from a U.S. port when you get the services, regardless of whether it’s an emergency.

Medicare doesn’t cover health care services you get when the ship is more than 6

hours away from a U.S. port.

Edited December 18, 2015 by cruisenfever

[AustinCruise]

As mentioned above, you can try filing it with your primary and just forwarding the denial to the travel insurance. If your primary won't cover at all because it's out of the country, ask them to list that as the primary denial reason. Then the codes won't matter anyway.

[dixieva]

When I filed my claim with Medicare it was denied because the doctor who provided the services was not licensed to practice in the U.S.

Edited December 18, 2015 by dixieva

[Pencruise]

So my son visited the ship doctor while we were on our last cruise and received some medication. I am attempting to get my insurance company to pay for it. According to my travel insurance, I need to go through my primary insurance first and they will cover what it doesn't pay.

 

My primary insurance says that the diagnostic codes used in the statement the ship doctor provided to me are invalid and that they need to correct it and send a new one. I contacted royal caribbean and they told me that royal uses their own diagnostic codes (?!?) and they will not correct it and there is also no way for me to contact the ship doctor. When I asked them what I was supposed to do next, the agent just shrugged "sorry". =(

 

The travel insurance also requires a form for the ship doctor to sign and date. How do I get this completed when I can't contact the ship doctor? Does anybody have any advice/experience about making a claim after a cruise? I feel like they have put up a few impossible hoops and expect me to just go "oh well".

 

When my husband received excellent treatment onboard the Allure last year and was referred to a specialist in St. Thomas, we wanted to thank the doctor onboard after we had left, so we wrote an e mail to Steve Williams and he forwarded the e mail to the ship, so I think he may be your best bet. Good luck.

[CT Sean]

I know a thing or two about insurance, specifically medical claims processing, what you might want to do is call your primary and ask them how foreign claims are handled. Foreign claims don't have the same coding guidelines and codesets that we have in the US so they generally have to be handled manually. Any attempt at automated processing is likely going to result in some sort of denial or closure for lack of key billing info.

[dreday3]

If the DGX codes are before 10 1 2015 then yes the DGX code would need to be updated since the new codes are different and no , insurance companies and Medicare will not use the old ones. Good luck!

 

That's not true actually, Medicare (and most other insurance companies) will still accept ICD 9 diagnosis codes for a year - one year grace period.

 

The U.S.A was one of the last countries (besides Italy I believe) to adopt the ICD 10 diagnosis coding classification system, so I'm thinking the Royal is already using ICD 10 since they are not based out of the U.S.

 

Also, the representative must have misunderstood you, and Royal could not have had their own "diagnostic" codes - perhaps they are saying the codes they used aren't payable for the service you received. Clarify with your insurance?

Edited December 18, 2015 by dreday3

[fenton04]

That's not true actually, Medicare (and most other insurance companies) will still accept ICD 9 diagnosis codes for a year - one year grace period.

 

 

 

The U.S.A was one of the last countries (besides Italy I believe) to adopt the ICD 10 diagnosis coding classification system, so I'm thinking the Royal is already using ICD 10 since they are not based out of the U.S.

 

 

 

Also, the representative must have misunderstood you, and Royal could not have had their own "diagnostic" codes - perhaps they are saying the codes they used aren't payable for the service you received. Clarify with your insurance?

 

 

That's odd when clients call me to update the ICD codes and gives me a ICD 9 codes the computer rejects them till they give me a ICD 10 code. Hmmm....

[AustinCruise]

I file claims for a doctor. For us anyway, only ICD-10 codes accepted now for BCBS, United, and Magellan. Not sure about the others. Source: working through rejected claims.

[k9x8]

I'm jumping through the same hoops. Travel insurance covered every penny of my hospital stay in Italy. No one even asked about primary, and the same woman called my husband every day to check on me. We've never seen the bill! However, I've had to submit to my primary for the $2000 ship board treatment. Go figure.

 

I have no idea how long it will take to get back the properly coded stuff, nor how long to wait before I ask my insurance to just go ahead and deny it. My adventure was on NCL. When I finally called Miami directly, the service lady was familiar with the "medical disembark" process. The request had to be made in writing, and she guided me to "post cruise comments" where I filled out the info and attached the correspondence from my company.

 

RCI might have something similar under "Contact Us."

Now if I can figure out how to get the records from the hospital.

 

Patience. It's a pain in the butt, but I know I'll get reimbursed one way or another. Meanwhile, I'm grateful for the hospital being covered with no up front payment required, as well as grateful for getting well, albeit in a (to me) very weird hospital.

Edited December 19, 2015 by k9x8