Re: Denied!!!! How can they do that - don't they understand

[Guest guest]

Marilyn,

I believe the people who run insurance companies need one requirement

for the job -no common sense!

I am in the same boat. I sent in so many pictures,graph and

explanations but I think because the ICD code the docs use to submit

for approval is the same for any gastric bypass it makes it easy for

them to say no.

Don't give up! I plan on appealing my denial and with the second

appeal I get to actually go before their board and argue my point.

Regardless I am planning on having the surgery next week and then I

will continue to fight them for them to reinburse me.

Good luck

Jen

MGB 5/24/00

[Guest guest]

So sorry Marilyn, sometimes insurance companies can't see the forest for the

trees!

fg

At 05:48 PM 05/19/2000 -0000, you wrote:

>Well, I just got the call from the insurance company. Denied!

>They say that a gastric bypass is a gastric bypass and that they are

>available locally.

>

>I sent them everthing....the comparisons to all the other surgeries

>from the website, the appeal letter with the comparison charts. I

>just can't believe they would do this.

>

>They want me to go locally and spend $40,000 of their customers money

>instead of seeing Dr. R and spending less that $14,000. As a

>consumer that makes me furious.

>

>I have Blue Choice (an HMO of BCBS) in Rochester NY. Yeah, Blue

>Choice....appearently named because they don't give you any.

>

>Sorry to vent, I haven't even told my family yet - I'm too

>upset...came to you all first. Thanks for letting me vent.

>

>Well I'm on my way to the appeal process, 3 levels of appeal, she

>said.

>

>So much for a date in June....can't wait to see how long this process

>takes...will Dr. R still have my stuff or will I have to send it

>again?

>

>I didn't suffer from depression when I started this process, but with

>facing the things I alway denied about myself and the gall-darned

>insurance beaurocrats...and the ups and downs this all brings I may

>be well on my way.

>

>You guys are the greatest!!! Thanks for being there.

>

>Marilyn

>

>

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