Insurance appeal meeting

[Guest guest]

Hi,

I tried to post yesterday, but it didn't seem to make it on there, so

I am trying again.

I have been fighting with my insurance company since March to get

approval for the MGB with Dr. Rutledge. My final appeal with MAMSI

Life and Health Insurance Company is this Thursday, June 8 at 4 pm.

I am working out a presentation where I document my medical problems

due to my weight as well as letters of support from my doctor and my

employer. As well, I am attempting to put together a cost list of

the medications that I have to take now and the possible cost of

future hospitalizations if a permanent solution is not found to my

weight problem. The purpose of this is to prove how cost effective

it would be for MAMSI to pay for Dr. Rutledge's surgery. Also, Iam

trying to bring out various points in Dr. Rutledge's wonderful appeal

letter regarding exclusion of coverage as that is the reason I am

being turned down.

Has anyone else had to deal with MAMSI Life and Health? It has been

very frustrating as I have seemed to get different information from

different people and essentially, they have not looked at medical

necessity at all. One of their employees told me that when Dr.

Rutledge sent in his first letter, it was stamped received and put in

my file and not even read since the procedure was one that was

excluded. I was really shocked by this. I sent them a some

documents on my first appeal and called to make sure they had

received it and was assurred that they had, but then the documents

were returned to me as I had inadvertently left a number off the

address. They had never received it! So I do not think they had

read anything. Now finally at this last appeal, I have a right to be

there. I am taking a packet of information, some of which they may

already have and will be handing it out to them to follow along as I

make by little presentation that I hope will save my life. If any of

you who have been through this before have any suggestions or ideas,

please let me know.

I can't tell you how much your e-mails and words of encouragement

mean to me. They have really helped build me up during this

frustrating time.

Carol S.