Re: approved after denial...yeah

[Guest guest]

Hi Jen,

Congratulations on your approval. I need some info. I also have

Prudential and my surgery was 5-31. They paid 80/20 out of network and I

want to see if I can get 100%. Is Dr. R one of your network doctors? What

kind of info did you send for them to approve in network. It would be great

if they would pay 100%. Please let me know.

Thanks,

Genz ( Genzel)

wrote:

> Hi everyone,

> Just wanted you all to know as I got very good news today. Prudential

> has agreed to pay in network benefits for my surgery.I attended my

> appeal on June 6 and today they told me they are giving a one time

> approval( I guess that's so they dont have to pay for everyone right

> off the bat)I only wish I had patience to wait for my approval b/c I

> self payed on 5/24. But I believe at least I should get most of it

> back. I also wanted to write this as I know people get discouraged

> when they are denied as I know I did(I believed they wouldn't pay so

> that is why I self payed). But just keep fighting for what you know

> is the best option for you. If anyone needs any ideas on fighting an

> appeal I would be glad to help.

> Bye for now I think I'll call the hosp. and try to work on my refund.

> Jen

> 5/24/00

> 25 lbs

> Now if I could just get rid of this stomach pain, everything would be

> great.

>

> ------------------------------------------------------------------------

> Remember four years of good friends, bad clothes, explosive chemistry

> experiments.

> http://click.egroups.com/1/5532/2/_/453517/_/961097499/

> ------------------------------------------------------------------------

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

[Guest guest]

Hi Jen,

Congratulations on your approval. I need some info. I also have

Prudential and my surgery was 5-31. They paid 80/20 out of network and I

want to see if I can get 100%. Is Dr. R one of your network doctors? What

kind of info did you send for them to approve in network. It would be great

if they would pay 100%. Please let me know.

Thanks,

Genz ( Genzel)

wrote:

> Hi everyone,

> Just wanted you all to know as I got very good news today. Prudential

> has agreed to pay in network benefits for my surgery.I attended my

> appeal on June 6 and today they told me they are giving a one time

> approval( I guess that's so they dont have to pay for everyone right

> off the bat)I only wish I had patience to wait for my approval b/c I

> self payed on 5/24. But I believe at least I should get most of it

> back. I also wanted to write this as I know people get discouraged

> when they are denied as I know I did(I believed they wouldn't pay so

> that is why I self payed). But just keep fighting for what you know

> is the best option for you. If anyone needs any ideas on fighting an

> appeal I would be glad to help.

> Bye for now I think I'll call the hosp. and try to work on my refund.

> Jen

> 5/24/00

> 25 lbs

> Now if I could just get rid of this stomach pain, everything would be

> great.

>

> ------------------------------------------------------------------------

> Remember four years of good friends, bad clothes, explosive chemistry

> experiments.

> http://click.egroups.com/1/5532/2/_/453517/_/961097499/

> ------------------------------------------------------------------------

>

> This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

> Please visit our web site at http://clos.net

> Get the Patient Manual at http://clos.net/get_patient_manual.htm

[Guest guest]

Dear ,

I just got the call and fax today. The letter states they will pay in

newtork benefits, so i believe that to be 100% less my copay if any.

The only problem is that if they have a negotiated rate with the hosp

than I might only be reimbursed at the that rate. Debbie told me that

whatever prudential would have paid them if all I have to pay so I

would not be liable for the rest. That is great. I will call my

ins.company tom. hopefully and try and get some info. I will let you

know. About Dr. R being in network, they told me earlier that he is a

provider but he is out of state so he is not considered in my

network. But luckily I changed their mind

talk to you soon

Jen

[Guest guest]

Dear ,

I just got the call and fax today. The letter states they will pay in

newtork benefits, so i believe that to be 100% less my copay if any.

The only problem is that if they have a negotiated rate with the hosp

than I might only be reimbursed at the that rate. Debbie told me that

whatever prudential would have paid them if all I have to pay so I

would not be liable for the rest. That is great. I will call my

ins.company tom. hopefully and try and get some info. I will let you

know. About Dr. R being in network, they told me earlier that he is a

provider but he is out of state so he is not considered in my

network. But luckily I changed their mind

talk to you soon

Jen

[Guest guest]

Jen - is it still too early to congratulate you? Or do we have to wait until

you get the check in your hand??? Well - early congratulations on being

approved anyway!!!!

xx,oo

M.

MGB 6/7/00

approved after denial...yeah

Hi everyone,

Just wanted you all to know as I got very good news today. Prudential

has agreed to pay in network benefits for my surgery.I attended my

appeal on June 6 and today they told me they are giving a one time

approval( I guess that's so they dont have to pay for everyone right

off the bat)I only wish I had patience to wait for my approval b/c I

self payed on 5/24. But I believe at least I should get most of it

back. I also wanted to write this as I know people get discouraged

when they are denied as I know I did(I believed they wouldn't pay so

that is why I self payed). But just keep fighting for what you know

is the best option for you. If anyone needs any ideas on fighting an

appeal I would be glad to help.

Bye for now I think I'll call the hosp. and try to work on my refund.

Jen

5/24/00

25 lbs

Now if I could just get rid of this stomach pain, everything would be

great.

------------------------------------------------------------------------------

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This message is from the Mini-Gastric Bypass Mailing List at Onelist.com

Please visit our web site at http://clos.net

Get the Patient Manual at http://clos.net/get_patient_manual.htm