prayers and good thoughts, please

[Guest guest]

In a message dated 8/1/2000 3:27:53 PM Eastern Daylight Time,

ChoctawGal@... writes:

<< The doctor that will be looking at it will be back from a vacation

tomorrow,

and it sounds like they will be making their decision then.

Thanks for listening.... keep tomorrow in your thoughts and prayers.

Thanks!!

Jenn in Vancouver, WA

waiting to cross.... trying to be patient >>

Jenn,

My thoughts and prayers are with you!!!! I'll keep my fingers and toes

crossed for you and I'll also be praying for you!!!!!

Cathy Morrow in Lenoir, NC

5' 0 "

216.5 Lbs.

BMI 42

A journey of a thousand miles begins with a single step

[Guest guest]

In a message dated 8/1/00 12:27:49 PM Pacific Daylight Time,

ChoctawGal@... writes:

<< The doctor that will be looking at it will be back from a vacation

tomorrow,

and it sounds like they will be making their decision then.

Thanks for listening.... keep tomorrow in your thoughts and prayers.

Thanks!!

Jenn in Vancouver, WA

waiting to cross.... trying to be patient

>>

Way to go Jenn! That Dr will get back, all tanned and rested, and that lady

will say, " You better approve this one! She came in here in person and even

sicced her lawyer on us!! " Not wanting the headache, he will apply the

proverbial rubber stamp! Hang in!

Regards,

Debbie in IL

Daughter MGB 8/9 Cigna (3rd appeal)--BMI 45

Counting on Cigna for Debbie (BMI 40) First request denied 7/21 :0(

[Guest guest]

Hi all!

I should be hearing tomorrow whether my complaint/grievance against my

insurer, ODS Health Plans, will be settled... approving me for the MGB.

Your thoughts and prayers would be appriciated.

I have had a rather interesting (read: aggrivating) time with my insurance

these past couple of weeks.

I was denied a few weeks ago due to a determination of, " not medically

necessary. " That got me all ticked off, because I *know* it is. I wrote up

an appeal letter of my own listing all the qualifying co-morbidities and

commenting on all of them individually as they affect me and my life. (I

have all except for gastric reflux and diabetes... but have a very STRONG

family history of diabetes, so that one was just a matter of time, IMNSHO.)

I decided to also call ODS for a copy of their criteria for gastric bypass,

which they said I didn't meet, so that I could write a better appeal letter

based on it. I was given quite a run-around, and told that they could not

give me a copy. (Which is a bald-faced lie.)

Sooo... I emailed while in tears with frustration. I emailed her a

copy of their denial letter and my appeal letter, just to get her opinion.

To my suprise, she asked to go to bat for me. ~~WOW!~~

It is amazing how fast the ball started rolling after that! She was able to

find out for me that they wanted more documentation of my co-morbidities.

Last Friday I went to my PCP. Actually, I tracked him down at the hospital!

I went to the department I used to work at (respiratory therapy), asked if

they had seen him, called a couple departments to see if he had procedures

scheduled in their departments anytime that day, and called the sleep lab,

where I needed to get a copy of my sleep study anyway, and found him!

LOL!!... I went over there and presented him with an official looking

statement stating all of my co-morbidities for him to sign. HE DID! *big

grin*

I faxed that, a coverletter with the name of the reviewer assigned to the

case, my grievance letter, and additional documentation- since I'd had just

been diagnosed officially with obstructive sleep apnea only a couple days

previously- to ODS. I also priority mailed the whole packed I just

mentioned, plus Dr. R's appeal letter to ODS as well.

Would you believe that after that, they claimed they didn't get it? I have

2 confirmation reciepts saying they did! Yet, they say they didn't get it.

GRRRRRR!

Finally, called them and got a street address that I could hand

deliver a copy of the packet to. They refused to give me that info, BTW.

(I always make and keep copies, thank goodness!) I got the address from

, hopped into the car, and drove to downtown Portland... thankfully

only a few miles away... I went up to the reception desk and asked to see

the reviewer (by name) and told her that I was going to hand deliver it to

her, and she was expecting it. (No, I did NOT want to leave it for the

receptionist to " lose " too.) She called the reviewer and I gave it to her.

*phew* Now I KNOW that it is where it needs to be.

The doctor that will be looking at it will be back from a vacation tomorrow,

and it sounds like they will be making their decision then.

Thanks for listening.... keep tomorrow in your thoughts and prayers.

Thanks!!

Jenn in Vancouver, WA

waiting to cross.... trying to be patient

________________________________________________________________________

Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com

[Guest guest]

> Hi all!

>

> I should be hearing tomorrow whether my complaint/grievance against

my

> insurer, ODS Health Plans, will be settled... approving me for the

MGB.

> Your thoughts and prayers would be appriciated.

>

> I have had a rather interesting (read: aggrivating) time with my

insurance

> these past couple of weeks.

>

> I was denied a few weeks ago due to a determination of, " not

medically

> necessary. " That got me all ticked off, because I *know* it is. I

wrote up

> an appeal letter of my own listing all the qualifying

co-morbidities

and

> commenting on all of them individually as they affect me and my

life. (I

> have all except for gastric reflux and diabetes... but have a very

STRONG

> family history of diabetes, so that one was just a matter of time,

IMNSHO.)

>

> I decided to also call ODS for a copy of their criteria for gastric

bypass,

> which they said I didn't meet, so that I could write a better

appeal

letter

> based on it. I was given quite a run-around, and told that they

could not

> give me a copy. (Which is a bald-faced lie.)

>

> Sooo... I emailed while in tears with frustration. I emailed

her a

> copy of their denial letter and my appeal letter, just to get her

opinion.

> To my suprise, she asked to go to bat for me. ~~WOW!~~

>

> It is amazing how fast the ball started rolling after that! She

was

able to

> find out for me that they wanted more documentation of my

co-morbidities.

>

> Last Friday I went to my PCP. Actually, I tracked him down at the

hospital!

> I went to the department I used to work at (respiratory therapy),

asked if

> they had seen him, called a couple departments to see if he had

procedures

> scheduled in their departments anytime that day, and called the

sleep lab,

> where I needed to get a copy of my sleep study anyway, and found

him!

> LOL!!... I went over there and presented him with an official

looking

> statement stating all of my co-morbidities for him to sign. HE

DID!

*big

> grin*

>

> I faxed that, a coverletter with the name of the reviewer assigned

to the

> case, my grievance letter, and additional documentation- since I'd

had just

> been diagnosed officially with obstructive sleep apnea only a

couple

days

> previously- to ODS. I also priority mailed the whole packed I just

> mentioned, plus Dr. R's appeal letter to ODS as well.

>

> Would you believe that after that, they claimed they didn't get it?

I have

> 2 confirmation reciepts saying they did! Yet, they say they didn't

get it.

> GRRRRRR!

>

> Finally, called them and got a street address that I could

hand

> deliver a copy of the packet to. They refused to give me that

info,

BTW.

> (I always make and keep copies, thank goodness!) I got the address

from

> , hopped into the car, and drove to downtown Portland...

thankfully

> only a few miles away... I went up to the reception desk and asked

to see

> the reviewer (by name) and told her that I was going to hand

deliver

it to

> her, and she was expecting it. (No, I did NOT want to leave it for

the

> receptionist to " lose " too.) She called the reviewer and I gave it

to her.

> *phew* Now I KNOW that it is where it needs to be.

>

> The doctor that will be looking at it will be back from a vacation

tomorrow,

> and it sounds like they will be making their decision then.

>

> Thanks for listening.... keep tomorrow in your thoughts and prayers.

>

> Thanks!!

> Jenn in Vancouver, WA

> waiting to cross.... trying to be patient

>

_

_____________________________________________________________________

__

> Get Your Private, Free E-mail from MSN Hotmail at

http://www.hotmail.com

MS Jenn, You are an inspiration to me. I hope that when I fianlly

find

something out it will be positive and if not I know that taking the

bull by the horns is the only way to get any thing accomplished...

keep us posted on your progress and Iwill say a long ans hard prayer

for you tonight....Good Luck to you,

Steph

[Guest guest]

Debbie in IL wrote:

<<<Way to go Jenn! That Dr will get back, all tanned and rested, and that

lady will say, " You better approve this one! She came in here in person and

even sicced her lawyer on us!! " Not wanting the headache, he will apply the

proverbial rubber stamp! Hang in!>>>

*great big smile*

That's what I'm hoping for!! LOL But, better yet, I hope this makes it

easier for whomever applies for approval after me.

Thanks to everyone who is praying!

My very best;

Jenn in Vancouver, WA

trying to concentrate on my homework but too excited/nervous about tomorrow.

LOL

________________________________________________________________________

Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com

[Guest guest]

You did good, Jenn! Can't wait to hear that you're approved!!

Tricia in IL

Ms Jenn wrote:

>

> Hi all!

>

> I should be hearing tomorrow whether my complaint/grievance against my

>

> insurer, ODS Health Plans, will be settled... approving me for the

> MGB.

> Your thoughts and prayers would be appriciated.

>

> I have had a rather interesting (read: aggrivating) time with my

> insurance

> these past couple of weeks.

>

> I was denied a few weeks ago due to a determination of, " not medically

>

> necessary. " That got me all ticked off, because I *know* it is. I

> wrote up

> an appeal letter of my own listing all the qualifying co-morbidities

> and

> commenting on all of them individually as they affect me and my life.

> (I

> have all except for gastric reflux and diabetes... but have a very

> STRONG

> family history of diabetes, so that one was just a matter of time,

> IMNSHO.)

>

> I decided to also call ODS for a copy of their criteria for gastric

> bypass,

> which they said I didn't meet, so that I could write a better appeal

> letter

> based on it. I was given quite a run-around, and told that they could

> not

> give me a copy. (Which is a bald-faced lie.)

>

> Sooo... I emailed while in tears with frustration. I emailed

> her a

> copy of their denial letter and my appeal letter, just to get her

> opinion.

> To my suprise, she asked to go to bat for me. ~~WOW!~~

>

> It is amazing how fast the ball started rolling after that! She was

> able to

> find out for me that they wanted more documentation of my

> co-morbidities.

>

> Last Friday I went to my PCP. Actually, I tracked him down at the

> hospital!

> I went to the department I used to work at (respiratory therapy),

> asked if

> they had seen him, called a couple departments to see if he had

> procedures

> scheduled in their departments anytime that day, and called the sleep

> lab,

> where I needed to get a copy of my sleep study anyway, and found him!

>

> LOL!!... I went over there and presented him with an official looking

> statement stating all of my co-morbidities for him to sign. HE DID!

> *big

> grin*

>

> I faxed that, a coverletter with the name of the reviewer assigned to

> the

> case, my grievance letter, and additional documentation- since I'd had

> just

> been diagnosed officially with obstructive sleep apnea only a couple

> days

> previously- to ODS. I also priority mailed the whole packed I just

> mentioned, plus Dr. R's appeal letter to ODS as well.

>

> Would you believe that after that, they claimed they didn't get it? I

> have

> 2 confirmation reciepts saying they did! Yet, they say they didn't

> get it.

> GRRRRRR!

>

> Finally, called them and got a street address that I could hand

> deliver a copy of the packet to. They refused to give me that info,

> BTW.

> (I always make and keep copies, thank goodness!) I got the address

> from

> , hopped into the car, and drove to downtown Portland...

> thankfully

> only a few miles away... I went up to the reception desk and asked to

> see

> the reviewer (by name) and told her that I was going to hand deliver

> it to

> her, and she was expecting it. (No, I did NOT want to leave it for

> the

> receptionist to " lose " too.) She called the reviewer and I gave it to

> her.

> *phew* Now I KNOW that it is where it needs to be.

>

> The doctor that will be looking at it will be back from a vacation

> tomorrow,

> and it sounds like they will be making their decision then.

>

> Thanks for listening.... keep tomorrow in your thoughts and prayers.

>

> Thanks!!

> Jenn in Vancouver, WA

> waiting to cross.... trying to be patient