Re: help needed for appeal

[Guest guest]

> HI guys

> I am having a level two appeal where I can attend and hopefully

Dr.R

> will be on the phone.

I've written about this a couple of times. I am having my Level II

appeal on June 1st. My insurance company is Healthsource now Cigna.

After speaking to the appeals representative, I felt that this still

was going to get approval because they where looking at as an

administrative appeal not a medically necessary appeal. I got

nervous about winning so last Friday I hired Walter Lindstrom. I fed-

exed all my documentation and he will be on a phone conference with

the committee on Thursday. Who is your insurance company? How did

you go about " booking " Dr. Rutledge for the phone conference. That's

a great idea. I didn't even think about it, but that should

certainly " carry some weight " . Wishing us both good luck and success.

, Denver NC. Fighting with Healthsource since 2/19.

[Guest guest]

Marilyn,

My ins. is with Prudential. I had the surgery on the 24 and self

payed but would like to get reimbursed. They were pushing a surgeon

who does the lap RNY and started doing it in June 99. Need I say more?

My appeal is June 6.I plan on attending it.I want them to put a face

with the name. Not just read a letter and deny.Dr R has said he will

participate it via telephone if I can secure an 8 am appeal. I plan

on calling them in the morning. I'm thinking and this is for anyone

who might wan to lend some input.I was thinking if they knew I had it

already they might deny me just b/c it's over and done with, but if I

can (and Dr R)convince them that this is a safer,cheaper and faster

recovery than the rny they might approve it beliving it is also

benefiting them. Than once I'm approved I can just give them my

bills. Any ideas? It would be great to be reimbursed.

thanks

Jen

5/24/00