Re: Just recived out second denial letter but...

[Guest guest]

I forgot to say it is really funny to me that we had to fight to get

to see Dr. H in the first place that was a battle in itself, but now

all the sudden when we fight a little more they offer us Dr. H or Dr.

Dobbs....I think fighting must help but I still think they do

everything in there power to make you want to give up.

>

> Michele

> Collin's story at http://www.geocities.com/chele323232

[Guest guest]

I forgot to say it is really funny to me that we had to fight to get

to see Dr. H in the first place that was a battle in itself, but now

all the sudden when we fight a little more they offer us Dr. H or Dr.

Dobbs....I think fighting must help but I still think they do

everything in there power to make you want to give up.

>

> Michele

> Collin's story at http://www.geocities.com/chele323232

[Guest guest]

*SIGH*

How frustrating - in a banging your head against a wall kind of way!

Have I ever mentioned my dislike for Aetna?

It's like they go out of their way to make things hard. If I had a

choice, I'd switch. However, I prefer a PPO to an HMO, so as long as

I'm working here it's not an option.

I'm sorry you are having to go through this ridiculous hoop-

jumping...if you can, keep trying. If you can't because you don't

have grounds to, well, I don't even know. THat's lame.

Have you tried getting your HR department involved? Sometimes they

can get things to happen.

Darby

Livi 3.15.04 bi cf p/m fab 16/7

> Well I just came home and recived a second letter, before I bash

> Aetna I would like to give then a compliment, they seem to be

growing

> a wee bit smarter and educated in the process...just a wee bit.

Our

> first rejection last week they said because there were ponseti

method

> doctors in our network at Children's Hospital of Philadelphia and

St.

> s. I appealed based on they don't practice the method

to

> a " T " nor are they on the " list " of " qualified " doctors. So this

> time they still denied us to see Dr. Ponseti, but they are getting

> smarter now and getting my point. This time they said we can see

Dr.

> Herzenberg (duhhh! We already see & love him, the whole idea of

> going to Dr. Ponseti was a second opinion...they must have to clean

> there ears out, I think they just don't listen when I talk). Or

they

> said we can go to (this is the part where I see them getting

> smarter)...St. Louis Children's Hospital in Missouri to see Dr.

> Dobbs. Ok I'm glad we can see Dr. Dobbs if we want to I would keep

> that in mind, but serously they are both so far away and probably

> cost the same amount so why not just give us a one time permission

to

> see Dr. Ponseti he does Accept Aetna I asked, it's just a different

> network.

> I don't think I have grounds now though for a level 2 appeal since

> they did list someone other then Dr. Herzenberg. So it looks like

we

> will be paying out of pocket now for our Dr. P visit. Unless any

of

> you know what I could say for a level 2 appeal. I'm not even sure

> whats closer to us now Iowa or Missouri, I'll have to go look at a

> map!

>

> Michele

> Collin's story at http://www.geocities.com/chele323232

[Guest guest]

*SIGH*

How frustrating - in a banging your head against a wall kind of way!

Have I ever mentioned my dislike for Aetna?

It's like they go out of their way to make things hard. If I had a

choice, I'd switch. However, I prefer a PPO to an HMO, so as long as

I'm working here it's not an option.

I'm sorry you are having to go through this ridiculous hoop-

jumping...if you can, keep trying. If you can't because you don't

have grounds to, well, I don't even know. THat's lame.

Have you tried getting your HR department involved? Sometimes they

can get things to happen.

Darby

Livi 3.15.04 bi cf p/m fab 16/7

> Well I just came home and recived a second letter, before I bash

> Aetna I would like to give then a compliment, they seem to be

growing

> a wee bit smarter and educated in the process...just a wee bit.

Our

> first rejection last week they said because there were ponseti

method

> doctors in our network at Children's Hospital of Philadelphia and

St.

> s. I appealed based on they don't practice the method

to

> a " T " nor are they on the " list " of " qualified " doctors. So this

> time they still denied us to see Dr. Ponseti, but they are getting

> smarter now and getting my point. This time they said we can see

Dr.

> Herzenberg (duhhh! We already see & love him, the whole idea of

> going to Dr. Ponseti was a second opinion...they must have to clean

> there ears out, I think they just don't listen when I talk). Or

they

> said we can go to (this is the part where I see them getting

> smarter)...St. Louis Children's Hospital in Missouri to see Dr.

> Dobbs. Ok I'm glad we can see Dr. Dobbs if we want to I would keep

> that in mind, but serously they are both so far away and probably

> cost the same amount so why not just give us a one time permission

to

> see Dr. Ponseti he does Accept Aetna I asked, it's just a different

> network.

> I don't think I have grounds now though for a level 2 appeal since

> they did list someone other then Dr. Herzenberg. So it looks like

we

> will be paying out of pocket now for our Dr. P visit. Unless any

of

> you know what I could say for a level 2 appeal. I'm not even sure

> whats closer to us now Iowa or Missouri, I'll have to go look at a

> map!

>

> Michele

> Collin's story at http://www.geocities.com/chele323232

[Guest guest]

I will keep trying, but I'm wondering if I even have grounds with them

now, since they put Dr. Dobbs as ok. I think they just like to play

games over at Aetna to try to make you give up. I haven't tried

working with the human resources because our medical is through my

husbands work and I'm sure they are just as beaurcratic as Aetna he

works for for the Sheriffs Department, and it seems big & beaurcratic

to me. I don't think they will have any interest in helping us. They

couldn't even promise him off to go to Iowa with us, which doesn't

help when making flight reservations. He would find out that week, so

instead my mother in law is going to come with us.

Michele

[Guest guest]

I will keep trying, but I'm wondering if I even have grounds with them

now, since they put Dr. Dobbs as ok. I think they just like to play

games over at Aetna to try to make you give up. I haven't tried

working with the human resources because our medical is through my

husbands work and I'm sure they are just as beaurcratic as Aetna he

works for for the Sheriffs Department, and it seems big & beaurcratic

to me. I don't think they will have any interest in helping us. They

couldn't even promise him off to go to Iowa with us, which doesn't

help when making flight reservations. He would find out that week, so

instead my mother in law is going to come with us.

Michele

[Guest guest]

Michele,

How frustating! Of course you have the grounds for a 2nd appeal. Don't

let them win. If you quit now, they will just win at their game and pat

themselves on the backs and give each other a high 5, etc. Please don't

give up. I know it is hard and exhausting, but keep trying. You will

drive them crazy and maybe then they will give in.

Shook

Retail Operations Manager/Baking Instructor

Vie de France Yamazaki, Inc.

2070 Chain Bridge Rd. Suite 500

Vienna, VA 22182

x374

x374

fax

[Guest guest]

ARRRGGHHH!!! Geez! Now they're just being STUBBORN!!! Is it a bunch

of 2 and 3 year olds running the place???

> Michele,

> How frustating! Of course you have the grounds for a 2nd appeal.

Don't

> let them win. If you quit now, they will just win at their game

and pat

> themselves on the backs and give each other a high 5, etc. Please

don't

> give up. I know it is hard and exhausting, but keep trying. You

will

> drive them crazy and maybe then they will give in.

>

>

>

>

> Shook

> Retail Operations Manager/Baking Instructor

> Vie de France Yamazaki, Inc.

> 2070 Chain Bridge Rd. Suite 500

> Vienna, VA 22182

> x374

> x374

> fax

>

>