...........You go GIRL!!!!!

[Guest guest]

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You are doing so well. I bet you feel like you are on top of the

world?

In MiniGastricBypass (AT) e, " "

wrote:

>

> Find out what doctors they approve. Get their average time in

> surgery for the procedure (usually 4-8 HOURS), their surgical fee,

> the

> anaesthesia fee, and the average hospital stay and hospital bill.

>

> Then show them how much less expensive it is and how much less time

> (1/2 hour in surgery and 1.5 days in hospital) you spend in the

> hospital and recovering, with the laparascopic version. Just the

1/2

> hour for surgery alone cuts the surgical bill, anaesthesia bill,

and

> hospital Operating room bill to less than 1/5 of what the open

> procedure costs.

>

> Insurance is about money. Show them how their decision will cost

> them

> *more* money and how the laparscopic MGB will cost them *less.*

>

> You might also pay a lawyer $25 to write a letter to them with

these

> facts and stating that since their decision appears to be

> nonsensical,

> arbitrary and capricious, they have breached their fiduciary duties

> under ERISA and that you intend to pursue your full rememdies under

> law against them if this is not remedied immediately.

>

>

>

>

>

> 47, 5'4 " , 249 lbs.

> Surg. date: May 18, 2000

> Current wt. (2 weeks, 1 day): 234 (that's a pound a day!)

> No complications, no problems, nada.

>

>

>

> > It took a month and numerous sends to get Cigna to acknowledge my

> > request for pre-approval. It took only eight days to get a

letter

> > back stating:

> >

> > " We have determined that although a gastric bypass may be

> > indicated, the laproscopic approach is not considered to be

> essential

> > for the necessary care and treatment of an illness or injury, and

> > therefore is not a covered expense. "

> >

> > I plan to appeal, but would like thoughts on my approach. It

> appears

> > to me that they are not denying me Gastric Bypass, they just

don't

> > want me to have it laproscopicly. Any ideas? Thoughts?

> >

> > Ann

> > Wanting to cross to the other side...