and Insurance

[Guest guest]

Dear ,

I feel terrible now making all this 'stink'. Bless your heart

having to wait so long, and shame on your insurance company. I think

that they seem to forget that we are the ones that are lining their

pockets. We Hired them, actually, if you want to look at it like

that. I am so frustrated. I called again today and the lady says

again...you don't need pre-authorization! You need to go get pre-

certified for the hospital. The hospital and Dr. R. are in the

network for my insurance. I guess I just don't understand the

lingo---YET---I am learning. Good luck and I will pray for you too,

.

Love,

> :

>

> I am in the same boat you are. I am on my second appeal. I am

> supposed to have an appointment with the grievance committee the

> first week of June. They haven't sent me my letter of confirmation

> yet. I had my hopes up because they said a medical professional

> specializing in the field that you wanted surgery for would be on

the

> committee when it reached this point. Well, I found out today that

> is not the case because the " Insurance Company " has already decided

> it was excluded and therefore not covered. The greiveance committee

> will be made of lay people to decide if what I am asking for is not

> really included in the exclusion. I am hoping I can prove that

> morbid obesity is different than obesity which is what was excluded.

>

> I am supposed to bring anything to the hearing with me that I want

to

> them consider. Does anyone have any ideas. I have all my PCP's

> support letters and Dr. R's insurance denial letter. If anyone went

> through this let me know. I may walk up the steps instead of

taking

> the elevator so that I am huffing and puffing when they interview

> me. Maybe I will scare them into approving my claim. I went to

my

> first clinic on 2/19 and have been fighting ever since. Thanks for

> listening. Rozycki, Denver, NC