I need to RANT (sorry) (and has anyone done this?)

[Guest guest]

BCBS-Alabama denied my first request for abdominoplasty/panniculectomy. I

have been trying to gather info and documentation for another try for a

couple of months now. It is like pulling teeth to get a letter from a doc,

and I understand this is mainly becuz they are so busy. BUT.....

Today I called for the umpteenth time to check on the letter my pcp promised

me over a month ago. At that time she said it would take " about a week. " Each

time I have called since the week was up, the nurse or receptionist would

tell me the file " is on her desk; it will probably be done by Friday. " This

past Fri, again, it still was not done. Someone was to check with her and get

back to me that same day and tell me when I could reasonably expect it to be

done. I never got a callback (not an unusual occurrence with ANY doc these

days, it seems).

Today the recep't put me on hold, went and supposedly checked with the doc,

and cam back and told me: " Doctor says that her priority is taking care of

sick patients, and letters just have to wait until she has time. No idea when

that will be. "

I was just flabbergasted at this response. I guess the fact that I am in pain

daily with my back problems from this pannus causing so much extra pressure

on my spinal arthritis and degenerative disc disease, does not qualify me as

a " sick patient. " I reminded the gal that I can barely get out of bed most

mornings and she reiterated the fact that this is " just a letter " that I am

waiting for. I said yes, but it is that letter that is hopefully going to

help solve my back pain and therefore as important and as much in need of

attention as any treatment she might be prescribing some other " sick

patient. " I said I would be happy to write the letter myself in fact, and

present it to Dr. B...... for her signature if that would speed things up. To

my amazement, she said that would be a great idea.

SO, has anyone done this? Written a letter for their doc to sign? If so, I'd

love a copy to help me draft a letter a doc might be willing to sign.

Jeez, I am so MAD. Thanks for listening to my griping.

Carol A

[Guest guest]

BCBS-Alabama denied my first request for abdominoplasty/panniculectomy. I

have been trying to gather info and documentation for another try for a

couple of months now. It is like pulling teeth to get a letter from a doc,

and I understand this is mainly becuz they are so busy. BUT.....

Today I called for the umpteenth time to check on the letter my pcp promised

me over a month ago. At that time she said it would take " about a week. " Each

time I have called since the week was up, the nurse or receptionist would

tell me the file " is on her desk; it will probably be done by Friday. " This

past Fri, again, it still was not done. Someone was to check with her and get

back to me that same day and tell me when I could reasonably expect it to be

done. I never got a callback (not an unusual occurrence with ANY doc these

days, it seems).

Today the recep't put me on hold, went and supposedly checked with the doc,

and cam back and told me: " Doctor says that her priority is taking care of

sick patients, and letters just have to wait until she has time. No idea when

that will be. "

I was just flabbergasted at this response. I guess the fact that I am in pain

daily with my back problems from this pannus causing so much extra pressure

on my spinal arthritis and degenerative disc disease, does not qualify me as

a " sick patient. " I reminded the gal that I can barely get out of bed most

mornings and she reiterated the fact that this is " just a letter " that I am

waiting for. I said yes, but it is that letter that is hopefully going to

help solve my back pain and therefore as important and as much in need of

attention as any treatment she might be prescribing some other " sick

patient. " I said I would be happy to write the letter myself in fact, and

present it to Dr. B...... for her signature if that would speed things up. To

my amazement, she said that would be a great idea.

SO, has anyone done this? Written a letter for their doc to sign? If so, I'd

love a copy to help me draft a letter a doc might be willing to sign.

Jeez, I am so MAD. Thanks for listening to my griping.

Carol A

[Guest guest]

Carol..........I gotta tell ya honestly.......I would HAVE to search for a

new doc. I know this is easier said then done......I am now making an appt

with my 4th PS guy. The fact that your doc responded to you in that manner

would show me that him/her considers your tt to be " cosmetic " .....this can't

be good for your insurance fight. Even if they think that, they should keep

those comments to themselves. Good luck in what ever you do.......I know it

isn't easy to switch docs,but it might be really nice to have someone that

you feel is in your corner......... P.

I need to RANT (sorry) (and has anyone done this?)

> BCBS-Alabama denied my first request for abdominoplasty/panniculectomy. I

> have been trying to gather info and documentation for another try for a

> couple of months now. It is like pulling teeth to get a letter from a doc,

> and I understand this is mainly becuz they are so busy. BUT.....

>

> Today I called for the umpteenth time to check on the letter my pcp

promised

> me over a month ago. At that time she said it would take " about a week. "

Each

> time I have called since the week was up, the nurse or receptionist would

> tell me the file " is on her desk; it will probably be done by Friday. "

This

> past Fri, again, it still was not done. Someone was to check with her and

get

> back to me that same day and tell me when I could reasonably expect it to

be

> done. I never got a callback (not an unusual occurrence with ANY doc these

> days, it seems).

>

> Today the recep't put me on hold, went and supposedly checked with the

doc,

> and cam back and told me: " Doctor says that her priority is taking care of

> sick patients, and letters just have to wait until she has time. No idea

when

> that will be. "

>

> I was just flabbergasted at this response. I guess the fact that I am in

pain

> daily with my back problems from this pannus causing so much extra

pressure

> on my spinal arthritis and degenerative disc disease, does not qualify me

as

> a " sick patient. " I reminded the gal that I can barely get out of bed most

> mornings and she reiterated the fact that this is " just a letter " that I

am

> waiting for. I said yes, but it is that letter that is hopefully going to

> help solve my back pain and therefore as important and as much in need of

> attention as any treatment she might be prescribing some other " sick

> patient. " I said I would be happy to write the letter myself in fact, and

> present it to Dr. B...... for her signature if that would speed things up.

To

> my amazement, she said that would be a great idea.

>

> SO, has anyone done this? Written a letter for their doc to sign? If so,

I'd

> love a copy to help me draft a letter a doc might be willing to sign.

>

> Jeez, I am so MAD. Thanks for listening to my griping.

>

> Carol A

>

>

>

[Guest guest]

Carol..........I gotta tell ya honestly.......I would HAVE to search for a

new doc. I know this is easier said then done......I am now making an appt

with my 4th PS guy. The fact that your doc responded to you in that manner

would show me that him/her considers your tt to be " cosmetic " .....this can't

be good for your insurance fight. Even if they think that, they should keep

those comments to themselves. Good luck in what ever you do.......I know it

isn't easy to switch docs,but it might be really nice to have someone that

you feel is in your corner......... P.

I need to RANT (sorry) (and has anyone done this?)

> BCBS-Alabama denied my first request for abdominoplasty/panniculectomy. I

> have been trying to gather info and documentation for another try for a

> couple of months now. It is like pulling teeth to get a letter from a doc,

> and I understand this is mainly becuz they are so busy. BUT.....

>

> Today I called for the umpteenth time to check on the letter my pcp

promised

> me over a month ago. At that time she said it would take " about a week. "

Each

> time I have called since the week was up, the nurse or receptionist would

> tell me the file " is on her desk; it will probably be done by Friday. "

This

> past Fri, again, it still was not done. Someone was to check with her and

get

> back to me that same day and tell me when I could reasonably expect it to

be

> done. I never got a callback (not an unusual occurrence with ANY doc these

> days, it seems).

>

> Today the recep't put me on hold, went and supposedly checked with the

doc,

> and cam back and told me: " Doctor says that her priority is taking care of

> sick patients, and letters just have to wait until she has time. No idea

when

> that will be. "

>

> I was just flabbergasted at this response. I guess the fact that I am in

pain

> daily with my back problems from this pannus causing so much extra

pressure

> on my spinal arthritis and degenerative disc disease, does not qualify me

as

> a " sick patient. " I reminded the gal that I can barely get out of bed most

> mornings and she reiterated the fact that this is " just a letter " that I

am

> waiting for. I said yes, but it is that letter that is hopefully going to

> help solve my back pain and therefore as important and as much in need of

> attention as any treatment she might be prescribing some other " sick

> patient. " I said I would be happy to write the letter myself in fact, and

> present it to Dr. B...... for her signature if that would speed things up.

To

> my amazement, she said that would be a great idea.

>

> SO, has anyone done this? Written a letter for their doc to sign? If so,

I'd

> love a copy to help me draft a letter a doc might be willing to sign.

>

> Jeez, I am so MAD. Thanks for listening to my griping.

>

> Carol A

>

>

>

[Guest guest]

Time for a new doc...but first write your own letter and get her to

sign it. The insurance companies will often ask for copies of office

notes, too, so you may need dates when you actually saw her and

complained about the back pain.

Good luck with your appeal. I know all too well what you're going

through. After 3 denials for a breast reduction, I'm now waiting to

hear if my appeal has been accepted for the Independent External

Review. It goes for a preliminary review first to see if it's even

accepted for the big appeal review...2 weeks later, it hasn't even

gotten to the preliminary review stage yet...I've been told " it's in

the system. " <sigh>

in NJ

************************

> Someone was to check with her and get back to me that same day and

tell me when I could reasonably expect it to be done. I never got a

callback

[Guest guest]

Time for a new doc...but first write your own letter and get her to

sign it. The insurance companies will often ask for copies of office

notes, too, so you may need dates when you actually saw her and

complained about the back pain.

Good luck with your appeal. I know all too well what you're going

through. After 3 denials for a breast reduction, I'm now waiting to

hear if my appeal has been accepted for the Independent External

Review. It goes for a preliminary review first to see if it's even

accepted for the big appeal review...2 weeks later, it hasn't even

gotten to the preliminary review stage yet...I've been told " it's in

the system. " <sigh>

in NJ

************************

> Someone was to check with her and get back to me that same day and

tell me when I could reasonably expect it to be done. I never got a

callback

[Guest guest]

Carol,

I have never had to do this before. I did have a thought. Since

your wonderful doctor (gag, gag) seems to only have time for you if you

are " sick " and if you can afford it, why not make an appointment. Now, I

didn't have BCBS but when I went in to see the PS I took in a list of

things that were causing me problems because of the panni hanging so far

down. So, if nothing else, maybe make a list of things such as repeated

urinary track infections, repeated yeast infections, repeated skin

rashes, back pain, a list medications you have been on for these

complaints, how long you have been on the medications, etc to take to

the appointment with you. If you can actually put this in letter form

for the doctor to have sign, that would put you one step ahead. It is

just a thought. Don't know if it would work or not.

Lori Owen - Denton, Texas

CHF 4/14/01 479 lbs.

SRVG 7/16/01 401 lbs.

Current Weight 335

Dr. Ritter/Dr. Bryce

On Fri, 14 Mar 2003 17:37:57 EST tuesdynite@... writes:

> BCBS-Alabama denied my first request for

> abdominoplasty/panniculectomy. I

> have been trying to gather info and documentation for another try

> for a

> couple of months now. It is like pulling teeth to get a letter from

> a doc,

> and I understand this is mainly becuz they are so busy. BUT.....

>

> Today I called for the umpteenth time to check on the letter my pcp

> promised

> me over a month ago. At that time she said it would take " about a

> week. " Each

> time I have called since the week was up, the nurse or receptionist

> would

> tell me the file " is on her desk; it will probably be done by

> Friday. " This

> past Fri, again, it still was not done. Someone was to check with

> her and get

> back to me that same day and tell me when I could reasonably expect

> it to be

> done. I never got a callback (not an unusual occurrence with ANY doc

> these

> days, it seems).

>

> Today the recep't put me on hold, went and supposedly checked with

> the doc,

> and cam back and told me: " Doctor says that her priority is taking

> care of

> sick patients, and letters just have to wait until she has time. No

> idea when

> that will be. "

>

> I was just flabbergasted at this response. I guess the fact that I

> am in pain

> daily with my back problems from this pannus causing so much extra

> pressure

> on my spinal arthritis and degenerative disc disease, does not

> qualify me as

> a " sick patient. " I reminded the gal that I can barely get out of

> bed most

> mornings and she reiterated the fact that this is " just a letter "

> that I am

> waiting for. I said yes, but it is that letter that is hopefully

> going to

> help solve my back pain and therefore as important and as much in

> need of

> attention as any treatment she might be prescribing some other " sick

>

> patient. " I said I would be happy to write the letter myself in

> fact, and

> present it to Dr. B...... for her signature if that would speed

> things up. To

> my amazement, she said that would be a great idea.

>

> SO, has anyone done this? Written a letter for their doc to sign? If

> so, I'd

> love a copy to help me draft a letter a doc might be willing to

> sign.

>

> Jeez, I am so MAD. Thanks for listening to my griping.

>

> Carol A

>

>

>

[Guest guest]

Carol,

I have never had to do this before. I did have a thought. Since

your wonderful doctor (gag, gag) seems to only have time for you if you

are " sick " and if you can afford it, why not make an appointment. Now, I

didn't have BCBS but when I went in to see the PS I took in a list of

things that were causing me problems because of the panni hanging so far

down. So, if nothing else, maybe make a list of things such as repeated

urinary track infections, repeated yeast infections, repeated skin

rashes, back pain, a list medications you have been on for these

complaints, how long you have been on the medications, etc to take to

the appointment with you. If you can actually put this in letter form

for the doctor to have sign, that would put you one step ahead. It is

just a thought. Don't know if it would work or not.

Lori Owen - Denton, Texas

CHF 4/14/01 479 lbs.

SRVG 7/16/01 401 lbs.

Current Weight 335

Dr. Ritter/Dr. Bryce

On Fri, 14 Mar 2003 17:37:57 EST tuesdynite@... writes:

> BCBS-Alabama denied my first request for

> abdominoplasty/panniculectomy. I

> have been trying to gather info and documentation for another try

> for a

> couple of months now. It is like pulling teeth to get a letter from

> a doc,

> and I understand this is mainly becuz they are so busy. BUT.....

>

> Today I called for the umpteenth time to check on the letter my pcp

> promised

> me over a month ago. At that time she said it would take " about a

> week. " Each

> time I have called since the week was up, the nurse or receptionist

> would

> tell me the file " is on her desk; it will probably be done by

> Friday. " This

> past Fri, again, it still was not done. Someone was to check with

> her and get

> back to me that same day and tell me when I could reasonably expect

> it to be

> done. I never got a callback (not an unusual occurrence with ANY doc

> these

> days, it seems).

>

> Today the recep't put me on hold, went and supposedly checked with

> the doc,

> and cam back and told me: " Doctor says that her priority is taking

> care of

> sick patients, and letters just have to wait until she has time. No

> idea when

> that will be. "

>

> I was just flabbergasted at this response. I guess the fact that I

> am in pain

> daily with my back problems from this pannus causing so much extra

> pressure

> on my spinal arthritis and degenerative disc disease, does not

> qualify me as

> a " sick patient. " I reminded the gal that I can barely get out of

> bed most

> mornings and she reiterated the fact that this is " just a letter "

> that I am

> waiting for. I said yes, but it is that letter that is hopefully

> going to

> help solve my back pain and therefore as important and as much in

> need of

> attention as any treatment she might be prescribing some other " sick

>

> patient. " I said I would be happy to write the letter myself in

> fact, and

> present it to Dr. B...... for her signature if that would speed

> things up. To

> my amazement, she said that would be a great idea.

>

> SO, has anyone done this? Written a letter for their doc to sign? If

> so, I'd

> love a copy to help me draft a letter a doc might be willing to

> sign.

>

> Jeez, I am so MAD. Thanks for listening to my griping.

>

> Carol A

>

>

>