Guest guest Posted January 31, 2000 Report Share Posted January 31, 2000 Hi All, Seems how at least a few are going out of plan for help, I will share how I got around the system. I had already had a standard decompression that wasn't working. My local neurosurgeons ran every test imaginable and couldn't figure out what was wrong with me. They still didn't want to refer me out of plan. My family doctor finally referred me to Dr. Milhorat. My first request was denied, and I had to appeal. During this appeal process, I would phone every day, at least once a day. I was finally approved for one visit. We decided on surgery, and I had to start the process all over again. Keep in mind that most HMO's will drag their feet when approving an out of plan proceedure. I started calling every day again, and was denied the first time. They sent one letter out at a time to my, primary doc, neurologist, Dr. Milhorat, and my local neurosurgeons. They would wait for a response and then move on to the next letter. I was getting very frustrated so Jeff (my husband) talked to the people in his benefits department. They phoned the HMO and I was approved that night. It really helped to get them involved. I had been told that morning that they still had to contact my local neurosurgeons! Good luck, and don't give up. Kathleen Quote Link to comment Share on other sites More sharing options...
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