Re: VERY sad. BC said no - shocking, huh?

[Guest guest]

,

Hope is not your bad. Hope is all we have. I ask this only because

I figure I've read most of the same books and posts as you: Is there

room for appeals? I don't want information about your personal

finance, but is it possible to go to Belgium for the less costly

version? But I thought I understood JRI was offering a pricing

arrangement that would make it competitive with Dr. de Smet. On the

other hand, short of mortgaging the rest of my life...I know I

couldn't even afford either of those options.

HOPE IS NOT " YOUR BAD " . Never feel that way. Don't quit until you

can't get up. There's got to be a way for you to get whole again.

It is sad, but it's not shocking. We must all begin with the

essential truth that " money does not like people. " BC is money. You

are people, and therefore...outside of their frame, they don't like

you because you're little and inconvenient. I'm sure I recall

there's a class action suit againgst BCCA over just this issue. You

could join...just to add to their discomfort, and the cost of their

lawyers. But that will likely take so long to play out in court that

we'll all be doddering and drooling in our rockers before you got a

resurf from it. You could join the suit to pave the way for needful

Hippies who will certainly come after you.

Whatever you do...never believe you did something bad, AND DON'T GIVE

UP UNTIL THEy TOSS THE SECOND SHOVELFUL OF DIRT ON YOUR CASKET. THEY

COULD MISS WITH THE FIRST...AND YOU MIGHT STILL MAKE A CLEAN GETAWAY.

Hobble on hippy...

Alan

> Welp, got word about 5 mins ago...BCCA said no coverage. Here's

the

> email I got from at JRI:

>

> I just received " the call " from Blue Cross. The request was

> denied. They will not approve it because the implant is considered

> investigational. Also, they will not pay for everything associated

> with the surgery and exclude the implant as previously hoped.

Sorry

> for the bad news.

>

> Bastards. BC that is...JRI has been great.

> My bad for getting my hopes up.

> I'll move on, but I'm pretty dang bumbed...I was so hopeful,

>

[Guest guest]

,

Hope is not your bad. Hope is all we have. I ask this only because

I figure I've read most of the same books and posts as you: Is there

room for appeals? I don't want information about your personal

finance, but is it possible to go to Belgium for the less costly

version? But I thought I understood JRI was offering a pricing

arrangement that would make it competitive with Dr. de Smet. On the

other hand, short of mortgaging the rest of my life...I know I

couldn't even afford either of those options.

HOPE IS NOT " YOUR BAD " . Never feel that way. Don't quit until you

can't get up. There's got to be a way for you to get whole again.

It is sad, but it's not shocking. We must all begin with the

essential truth that " money does not like people. " BC is money. You

are people, and therefore...outside of their frame, they don't like

you because you're little and inconvenient. I'm sure I recall

there's a class action suit againgst BCCA over just this issue. You

could join...just to add to their discomfort, and the cost of their

lawyers. But that will likely take so long to play out in court that

we'll all be doddering and drooling in our rockers before you got a

resurf from it. You could join the suit to pave the way for needful

Hippies who will certainly come after you.

Whatever you do...never believe you did something bad, AND DON'T GIVE

UP UNTIL THEy TOSS THE SECOND SHOVELFUL OF DIRT ON YOUR CASKET. THEY

COULD MISS WITH THE FIRST...AND YOU MIGHT STILL MAKE A CLEAN GETAWAY.

Hobble on hippy...

Alan

> Welp, got word about 5 mins ago...BCCA said no coverage. Here's

the

> email I got from at JRI:

>

> I just received " the call " from Blue Cross. The request was

> denied. They will not approve it because the implant is considered

> investigational. Also, they will not pay for everything associated

> with the surgery and exclude the implant as previously hoped.

Sorry

> for the bad news.

>

> Bastards. BC that is...JRI has been great.

> My bad for getting my hopes up.

> I'll move on, but I'm pretty dang bumbed...I was so hopeful,

>

[Guest guest]

,

Don't give up. A friend of mine had her resurfacing today at JRI and

it is paid for by worker's comp. It seems to me that is the great

State of California is paying then so should other insurance

companies.

By the way, I did mortgage my house in the event BC/BS Gov Emp didn't

pay. I received the okay on Fri at 3:00pm. Surgery was on Monday

morning.

Good Luck,

Pamela

bilat 5/10/04 Dr. S

[Guest guest]

,

Don't give up. A friend of mine had her resurfacing today at JRI and

it is paid for by worker's comp. It seems to me that is the great

State of California is paying then so should other insurance

companies.

By the way, I did mortgage my house in the event BC/BS Gov Emp didn't

pay. I received the okay on Fri at 3:00pm. Surgery was on Monday

morning.

Good Luck,

Pamela

bilat 5/10/04 Dr. S

[Guest guest]

,

I am very sorry about your frustrating news (ok, I know that is an

understatement...). I do not live in CA and do not know the

specifics of your insurance or the state legislation (I'm from

Alabama if that tells you anything). What I DO know about is

fighting with slippery insurance companies (I wish I knew about it

from a more successful standpoint).

I don't know where you work, but if it is a large enough company (or

small enough to really have the support of the co.) you may have

another option. I work at a major university and our human resource

deptartment has what is kind of like an advocate that can step in and

fight the insurance on your behalf. Usually, they will only do this

if you have exhausted all of the regular channels of appeal. This

method comes at it from two perspectives, 1. Your company needs you

to be healthy and able to do your job (which is generally why

employers offer all of the various insurances anyway) and 2. Your

company has consumer power with the insurance company and can talk to

them in a language they understand 'money.' Just a thought

Amy

> Welp, got word about 5 mins ago...BCCA said no coverage. Here's

the

> email I got from at JRI:

>

> I just received " the call " from Blue Cross. The request was

> denied. They will not approve it because the implant is considered

> investigational. Also, they will not pay for everything associated

> with the surgery and exclude the implant as previously hoped.

Sorry

> for the bad news.

>

> Bastards. BC that is...JRI has been great.

> My bad for getting my hopes up.

> I'll move on, but I'm pretty dang bumbed...I was so hopeful,

>

[Guest guest]

,

I am very sorry about your frustrating news (ok, I know that is an

understatement...). I do not live in CA and do not know the

specifics of your insurance or the state legislation (I'm from

Alabama if that tells you anything). What I DO know about is

fighting with slippery insurance companies (I wish I knew about it

from a more successful standpoint).

I don't know where you work, but if it is a large enough company (or

small enough to really have the support of the co.) you may have

another option. I work at a major university and our human resource

deptartment has what is kind of like an advocate that can step in and

fight the insurance on your behalf. Usually, they will only do this

if you have exhausted all of the regular channels of appeal. This

method comes at it from two perspectives, 1. Your company needs you

to be healthy and able to do your job (which is generally why

employers offer all of the various insurances anyway) and 2. Your

company has consumer power with the insurance company and can talk to

them in a language they understand 'money.' Just a thought

Amy

> Welp, got word about 5 mins ago...BCCA said no coverage. Here's

the

> email I got from at JRI:

>

> I just received " the call " from Blue Cross. The request was

> denied. They will not approve it because the implant is considered

> investigational. Also, they will not pay for everything associated

> with the surgery and exclude the implant as previously hoped.

Sorry

> for the bad news.

>

> Bastards. BC that is...JRI has been great.

> My bad for getting my hopes up.

> I'll move on, but I'm pretty dang bumbed...I was so hopeful,

>

[Guest guest]

Bummer ...

You might ask them if they cover procedures in foreign countries. This is a

serious option to consider. In my case, there would have been a big hassle

getting approval for a US investigational implant, but as long as it is an

approved procedure wherever I got it done, all I had to do was submit the

paperwork. The representative told me that they shoo it through since a

procedure in a foreign country is considered an emergency (yeah, right,

every other country is in the Third World, sheesh). They paid for

everything associated with the procedure, except for one x-ray, so it cost

me $70 for my new hip. > No travel/lodging is not considered

reimbursable.

Might be at least worth a phone call...

Cheers,

Jeff

rBHR Aug.1, 2001

Mr/ McMinn

>,

>

>I am very sorry about your frustrating news (ok, I know that is an

>understatement...). I do not live in CA and do not know the

>specifics of your insurance or the state legislation (I'm from

>Alabama if that tells you anything). What I DO know about is

>fighting with slippery insurance companies (I wish I knew about it

>from a more successful standpoint).

>

>I don't know where you work, but if it is a large enough company (or

>small enough to really have the support of the co.) you may have

>another option. I work at a major university and our human resource

>deptartment has what is kind of like an advocate that can step in and

>fight the insurance on your behalf. Usually, they will only do this

>if you have exhausted all of the regular channels of appeal. This

>method comes at it from two perspectives, 1. Your company needs you

>to be healthy and able to do your job (which is generally why

>employers offer all of the various insurances anyway) and 2. Your

>company has consumer power with the insurance company and can talk to

>them in a language they understand 'money.' Just a thought

>

>Amy

>

>

>> Welp, got word about 5 mins ago...BCCA said no coverage. Here's

>the

>> email I got from at JRI:

>>

>> I just received " the call " from Blue Cross. The request was

>> denied. They will not approve it because the implant is considered

>> investigational. Also, they will not pay for everything associated

>> with the surgery and exclude the implant as previously hoped.

>Sorry

>> for the bad news.

>>

>> Bastards. BC that is...JRI has been great.

>> My bad for getting my hopes up.

>> I'll move on, but I'm pretty dang bumbed...I was so hopeful,

>>

>

>

>

>

>

>

[Guest guest]

Bummer ...

You might ask them if they cover procedures in foreign countries. This is a

serious option to consider. In my case, there would have been a big hassle

getting approval for a US investigational implant, but as long as it is an

approved procedure wherever I got it done, all I had to do was submit the

paperwork. The representative told me that they shoo it through since a

procedure in a foreign country is considered an emergency (yeah, right,

every other country is in the Third World, sheesh). They paid for

everything associated with the procedure, except for one x-ray, so it cost

me $70 for my new hip. > No travel/lodging is not considered

reimbursable.

Might be at least worth a phone call...

Cheers,

Jeff

rBHR Aug.1, 2001

Mr/ McMinn

>,

>

>I am very sorry about your frustrating news (ok, I know that is an

>understatement...). I do not live in CA and do not know the

>specifics of your insurance or the state legislation (I'm from

>Alabama if that tells you anything). What I DO know about is

>fighting with slippery insurance companies (I wish I knew about it

>from a more successful standpoint).

>

>I don't know where you work, but if it is a large enough company (or

>small enough to really have the support of the co.) you may have

>another option. I work at a major university and our human resource

>deptartment has what is kind of like an advocate that can step in and

>fight the insurance on your behalf. Usually, they will only do this

>if you have exhausted all of the regular channels of appeal. This

>method comes at it from two perspectives, 1. Your company needs you

>to be healthy and able to do your job (which is generally why

>employers offer all of the various insurances anyway) and 2. Your

>company has consumer power with the insurance company and can talk to

>them in a language they understand 'money.' Just a thought

>

>Amy

>

>

>> Welp, got word about 5 mins ago...BCCA said no coverage. Here's

>the

>> email I got from at JRI:

>>

>> I just received " the call " from Blue Cross. The request was

>> denied. They will not approve it because the implant is considered

>> investigational. Also, they will not pay for everything associated

>> with the surgery and exclude the implant as previously hoped.

>Sorry

>> for the bad news.

>>

>> Bastards. BC that is...JRI has been great.

>> My bad for getting my hopes up.

>> I'll move on, but I'm pretty dang bumbed...I was so hopeful,

>>

>

>

>

>

>

>

[Guest guest]

Jeff...

Granted insurance companies differ in these things, but you seem to

have opened up a whole set of avenues for the hippies among us who

are left adrift by uncooperative carriers.

Thanks...

Alan

> >> Welp, got word about 5 mins ago...BCCA said no coverage. Here's

> >the

> >> email I got from at JRI:

> >>

> >> I just received " the call " from Blue Cross. The request was

> >> denied. They will not approve it because the implant is

considered

> >> investigational. Also, they will not pay for everything

associated

> >> with the surgery and exclude the implant as previously hoped.

> >Sorry

> >> for the bad news.

> >>

> >> Bastards. BC that is...JRI has been great.

> >> My bad for getting my hopes up.

> >> I'll move on, but I'm pretty dang bumbed...I was so hopeful,

> >>

> >

> >

> >

> >

> >

> >