Re: Preliminary Insurance Rejection

[Guest guest]

Dear Teri,

Of course you are in my thoughts. Believe me if there is anything they

can do they will. I will also keep my fingers crossed (that used to work for

me when I was a child) that you will have the procedure you want, where you

want, and with the Dr. you want.

Terry

12/5/00 - Sleeve gastrectomy

6/26/01 - Second part

[Guest guest]

Dear Teri,

Of course you are in my thoughts. Believe me if there is anything they

can do they will. I will also keep my fingers crossed (that used to work for

me when I was a child) that you will have the procedure you want, where you

want, and with the Dr. you want.

Terry

12/5/00 - Sleeve gastrectomy

6/26/01 - Second part

[Guest guest]

Terri you keep your head up and eyes open all will fall into place!

It never ceases to amaze me how much bureaucracy plays in all our

lives ... But hang in there I am going thru pretty much the same

thing and I will not get upset and let my emotions start controlling

me! stay stead fast in this journey and all will work out! And yes I

will keep you in my prayers as you requested ..

~SHELLY~

> So, this morning I got a call from Darryl , the insurance

> specialist at Dr Pomp's office. He said he had some bad news; that

> my surgery for May 9th had been denied by my insurance because they

> wouldn't let me go out-of network.

>

> While I was on the phone with him, my phone rang again and went

> through to my voicemail. It was the case manager, Beth Searle,

from

> my insurance (CDPHP). When I returned her call she explained it

was

> denied because " there are surgeons in Albany who do this type of

> procedure " . Apparently she thought I was going all the way to Mt

> Sinai in NYC because I wanted a " Lap " weight loss surgery.

>

> When I explained to her the difference between the BPD/DS and the

RNY

> being done here in Albany she seemed to understand because she said

> that she didn't blame me for going to a surgeon who specializes in

> the type of surgery I want. So she said she wanted a short letter

> from Dr Pomp explaining that there are no doctors in Albany who

> perform this type of procedure and list some reasons " .

>

> When I quoted the request to Mr he said he didn't

understand

> (like, how would Dr Pomp know why there is no one doing DS in

> Albany?) He told me to have Ms Searle call him directly and

explain

> what she needed. I left her a voicemail to that effect and then

> quickly wrote and faxed her a letter recapping our conversation and

> highlighted the main differences between DS and RNY. I also asked

> her to contact Darryl directly in my letter.

>

> So that is where things stand for me. Even though I received a

> denial, the case manager sounded so understanding and willing to

help

> that I am hoping against hope that she might see it through for

me.

> Whether it falls into place by Wednesday is highly unlikely. But

> overall I am feeling pretty good that there is still cause for a

> glimmer of hope that I will get this surgery in the near future.

>

> Please include me in your prayers and good thoughts that everything

> will come together for me. Thank you, everyone for all your

support

> and help. You're the BEST!

>

> Terri Hassiak

> BMI 60

> http://www.obesityhelp.com/morbidobesity/profile.phtml?N=H980366398

> email(no spaces): bunsofluff @ hotmail.com

[Guest guest]

Terri you keep your head up and eyes open all will fall into place!

It never ceases to amaze me how much bureaucracy plays in all our

lives ... But hang in there I am going thru pretty much the same

thing and I will not get upset and let my emotions start controlling

me! stay stead fast in this journey and all will work out! And yes I

will keep you in my prayers as you requested ..

~SHELLY~

> So, this morning I got a call from Darryl , the insurance

> specialist at Dr Pomp's office. He said he had some bad news; that

> my surgery for May 9th had been denied by my insurance because they

> wouldn't let me go out-of network.

>

> While I was on the phone with him, my phone rang again and went

> through to my voicemail. It was the case manager, Beth Searle,

from

> my insurance (CDPHP). When I returned her call she explained it

was

> denied because " there are surgeons in Albany who do this type of

> procedure " . Apparently she thought I was going all the way to Mt

> Sinai in NYC because I wanted a " Lap " weight loss surgery.

>

> When I explained to her the difference between the BPD/DS and the

RNY

> being done here in Albany she seemed to understand because she said

> that she didn't blame me for going to a surgeon who specializes in

> the type of surgery I want. So she said she wanted a short letter

> from Dr Pomp explaining that there are no doctors in Albany who

> perform this type of procedure and list some reasons " .

>

> When I quoted the request to Mr he said he didn't

understand

> (like, how would Dr Pomp know why there is no one doing DS in

> Albany?) He told me to have Ms Searle call him directly and

explain

> what she needed. I left her a voicemail to that effect and then

> quickly wrote and faxed her a letter recapping our conversation and

> highlighted the main differences between DS and RNY. I also asked

> her to contact Darryl directly in my letter.

>

> So that is where things stand for me. Even though I received a

> denial, the case manager sounded so understanding and willing to

help

> that I am hoping against hope that she might see it through for

me.

> Whether it falls into place by Wednesday is highly unlikely. But

> overall I am feeling pretty good that there is still cause for a

> glimmer of hope that I will get this surgery in the near future.

>

> Please include me in your prayers and good thoughts that everything

> will come together for me. Thank you, everyone for all your

support

> and help. You're the BEST!

>

> Terri Hassiak

> BMI 60

> http://www.obesityhelp.com/morbidobesity/profile.phtml?N=H980366398

> email(no spaces): bunsofluff @ hotmail.com

[Guest guest]

HI Terri,

Sending good thoughts and positive vibes your way so that you get your surgery APPROVED!!! HMMMM.........does the swinging chickens thing also work for getting surgery approved? If so, I'll be finding me some chickens to swing for you!!

Keep us posted.

Pam

Pre-op in MD

Dr. Vanguri

Surgery date July 9, 2001

[Guest guest]

HI Terri,

Sending good thoughts and positive vibes your way so that you get your surgery APPROVED!!! HMMMM.........does the swinging chickens thing also work for getting surgery approved? If so, I'll be finding me some chickens to swing for you!!

Keep us posted.

Pam

Pre-op in MD

Dr. Vanguri

Surgery date July 9, 2001