Guest guest Posted December 20, 2000 Report Share Posted December 20, 2000 Well my good friends, I have some news on the insurance front. Evidently I made a big enough stink to the insurance company about the biases the insurance doctor has against bariatric surgery. They called me today and are now sending my complete medical history to Utah for an independent evaluation by a bariatric surgeon there. Dont know if this is a good thing or not but its still another step before I do an appeal. I am assuming they took back the denial after I sent them even more nutritional information. I still have an appeal date set and am not going to change that for now, unless they tell me different. I am just hoping and praying they dont tell me I have to have it done in Utah now. Ok ok now I need to settle down and stop thinking this way, right?? Let me know what you think I am most interested in the opinions of my MGB friends. Love to all of you Pat Iurato Nevada Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 20, 2000 Report Share Posted December 20, 2000 I am so excited, maybe this is a positive step to help you get closer to a date and crossing over... I hope so Pat. I guess when women scream it does make a difference... Keep us up on what happens. May your road get smoother... Connie My Insurance Update > Well my good friends, I have some news on the insurance front. > Evidently I made a big enough stink to the insurance company about > the biases the insurance doctor has against bariatric surgery. They > called me today and are now sending my complete medical history to > Utah for an independent evaluation by a bariatric surgeon there. Dont > know if this is a good thing or not but its still another step before > I do an appeal. I am assuming they took back the denial after I sent > them even more nutritional information. I still have an appeal date > set and am not going to change that for now, unless they tell me > different. I am just hoping and praying they dont tell me I have to > have it done in Utah now. Ok ok now I need to settle down and stop > thinking this way, right?? Let me know what you think I am most > interested in the opinions of my MGB friends. > Love to all of you > Pat Iurato > Nevada > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2000 Report Share Posted December 21, 2000 Sounds good, Pat. A bariatric surgeon has to be in favor of surgery, right? And familiar with BMI's and medical necessity, right? Sounds like you're moving in the right direction. Keep the faith! PhillyJude Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2000 Report Share Posted December 21, 2000 Oh Tari, I can relate so well to those stall tactics. I believe they think if they continue to stall they will wear us down. Not this time!!!!!!!! They did all of this to me 2 years ago and I gave up but I wont let them get me again. Keep fighting them as long as it takes. I cant believe they change the criteria right in the middle of your battle, how convient!! What were your medical necessities? Are you gonna hire an attorney? Keep in touch Pat Nevada Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2000 Report Share Posted December 21, 2000 Thanks Jude. Pat Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2000 Report Share Posted December 21, 2000 Thanks Jude. Pat Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2000 Report Share Posted December 21, 2000 Dear Pat, If they were going to flat out continue in their denial they certainly wouldn't have bothered to get the Utah review. Hopefully, an independent evaluation will have less bias and you can get some relief from them. I just hope it is not a stall tactic. My news late yesterday was not as optimistic. As you know I had my Grievance Committee Meeting on Tuesday. They called saying the denial was still upheld on the grounds of lack of medical necessity. I responded that I had a copy of their criteria and in the meeting had done a thorough review of how their criteria was met. She stated that they had a different criteria and I didn't meet the new one. (The old one was the one they provided to the Missouri Department of Insurance in response to my complaint.) She said when they send the denial letter that they will send a copy of the " new " criteria that I don't meet. It's hard to play the game when they keep changing the rules. Keep me updated on your game. Tarri in Missouri MGB 09-29-00 329/269 My Insurance Update > Well my good friends, I have some news on the insurance front. > Evidently I made a big enough stink to the insurance company about > the biases the insurance doctor has against bariatric surgery. They > called me today and are now sending my complete medical history to > Utah for an independent evaluation by a bariatric surgeon there. Dont > know if this is a good thing or not but its still another step before > I do an appeal. I am assuming they took back the denial after I sent > them even more nutritional information. I still have an appeal date > set and am not going to change that for now, unless they tell me > different. I am just hoping and praying they dont tell me I have to > have it done in Utah now. Ok ok now I need to settle down and stop > thinking this way, right?? Let me know what you think I am most > interested in the opinions of my MGB friends. > Love to all of you > Pat Iurato > Nevada > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2000 Report Share Posted December 22, 2000 GOOD LUCK! THINK POSITIVE! Cathy > >Reply-To: MiniGastricBypass (AT) egroups (DOT) com >To: MiniGastricBypass (AT) egroups (DOT) com >Subject: My Insurance Update >Date: Thu, 21 Dec 2000 00:10:49 -0000 > >Well my good friends, I have some news on the insurance front. >Evidently I made a big enough stink to the insurance company about >the biases the insurance doctor has against bariatric surgery. They >called me today and are now sending my complete medical history to >Utah for an independent evaluation by a bariatric surgeon there. Dont >know if this is a good thing or not but its still another step before >I do an appeal. I am assuming they took back the denial after I sent >them even more nutritional information. I still have an appeal date >set and am not going to change that for now, unless they tell me >different. I am just hoping and praying they dont tell me I have to >have it done in Utah now. Ok ok now I need to settle down and stop >thinking this way, right?? Let me know what you think I am most >interested in the opinions of my MGB friends. >Love to all of you >Pat Iurato >Nevada > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2000 Report Share Posted December 22, 2000 GOOD LUCK! THINK POSITIVE! Cathy > >Reply-To: MiniGastricBypass (AT) egroups (DOT) com >To: MiniGastricBypass (AT) egroups (DOT) com >Subject: My Insurance Update >Date: Thu, 21 Dec 2000 00:10:49 -0000 > >Well my good friends, I have some news on the insurance front. >Evidently I made a big enough stink to the insurance company about >the biases the insurance doctor has against bariatric surgery. They >called me today and are now sending my complete medical history to >Utah for an independent evaluation by a bariatric surgeon there. Dont >know if this is a good thing or not but its still another step before >I do an appeal. I am assuming they took back the denial after I sent >them even more nutritional information. I still have an appeal date >set and am not going to change that for now, unless they tell me >different. I am just hoping and praying they dont tell me I have to >have it done in Utah now. Ok ok now I need to settle down and stop >thinking this way, right?? Let me know what you think I am most >interested in the opinions of my MGB friends. >Love to all of you >Pat Iurato >Nevada > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2000 Report Share Posted December 22, 2000 Tarri, I am really sorry to hear that you got " screwed " ( pardon my french) at your grievance hearing. I hope that you won't give up...perhaps it is time for a lawyer, if that is feasible. Hang in there. Cathy > >Reply-To: MiniGastricBypass (AT) egroups (DOT) com >To: <MiniGastricBypass (AT) egroups (DOT) com> >Subject: Re: My Insurance Update >Date: Thu, 21 Dec 2000 08:17:55 -0600 > >Dear Pat, >If they were going to flat out continue in their denial they certainly >wouldn't have bothered to get the Utah review. Hopefully, an independent >evaluation will have less bias and you can get some relief from them. I >just hope it is not a stall tactic. >My news late yesterday was not as optimistic. As you know I had my >Grievance Committee Meeting on Tuesday. They called saying the denial was >still upheld on the grounds of lack of medical necessity. I responded that >I had a copy of their criteria and in the meeting had done a thorough >review >of how their criteria was met. She stated that they had a different >criteria and I didn't meet the new one. (The old one was the one they >provided to the Missouri Department of Insurance in response to my >complaint.) She said when they send the denial letter that they will send >a >copy of the " new " criteria that I don't meet. >It's hard to play the game when they keep changing the rules. >Keep me updated on your game. >Tarri in Missouri >MGB 09-29-00 >329/269 > My Insurance Update > > > > Well my good friends, I have some news on the insurance front. > > Evidently I made a big enough stink to the insurance company about > > the biases the insurance doctor has against bariatric surgery. They > > called me today and are now sending my complete medical history to > > Utah for an independent evaluation by a bariatric surgeon there. Dont > > know if this is a good thing or not but its still another step before > > I do an appeal. I am assuming they took back the denial after I sent > > them even more nutritional information. I still have an appeal date > > set and am not going to change that for now, unless they tell me > > different. I am just hoping and praying they dont tell me I have to > > have it done in Utah now. Ok ok now I need to settle down and stop > > thinking this way, right?? Let me know what you think I am most > > interested in the opinions of my MGB friends. > > Love to all of you > > Pat Iurato > > Nevada > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2000 Report Share Posted December 22, 2000 Tarri, I am really sorry to hear that you got " screwed " ( pardon my french) at your grievance hearing. I hope that you won't give up...perhaps it is time for a lawyer, if that is feasible. Hang in there. Cathy > >Reply-To: MiniGastricBypass (AT) egroups (DOT) com >To: <MiniGastricBypass (AT) egroups (DOT) com> >Subject: Re: My Insurance Update >Date: Thu, 21 Dec 2000 08:17:55 -0600 > >Dear Pat, >If they were going to flat out continue in their denial they certainly >wouldn't have bothered to get the Utah review. Hopefully, an independent >evaluation will have less bias and you can get some relief from them. I >just hope it is not a stall tactic. >My news late yesterday was not as optimistic. As you know I had my >Grievance Committee Meeting on Tuesday. They called saying the denial was >still upheld on the grounds of lack of medical necessity. I responded that >I had a copy of their criteria and in the meeting had done a thorough >review >of how their criteria was met. She stated that they had a different >criteria and I didn't meet the new one. (The old one was the one they >provided to the Missouri Department of Insurance in response to my >complaint.) She said when they send the denial letter that they will send >a >copy of the " new " criteria that I don't meet. >It's hard to play the game when they keep changing the rules. >Keep me updated on your game. >Tarri in Missouri >MGB 09-29-00 >329/269 > My Insurance Update > > > > Well my good friends, I have some news on the insurance front. > > Evidently I made a big enough stink to the insurance company about > > the biases the insurance doctor has against bariatric surgery. They > > called me today and are now sending my complete medical history to > > Utah for an independent evaluation by a bariatric surgeon there. Dont > > know if this is a good thing or not but its still another step before > > I do an appeal. I am assuming they took back the denial after I sent > > them even more nutritional information. I still have an appeal date > > set and am not going to change that for now, unless they tell me > > different. I am just hoping and praying they dont tell me I have to > > have it done in Utah now. Ok ok now I need to settle down and stop > > thinking this way, right?? Let me know what you think I am most > > interested in the opinions of my MGB friends. > > Love to all of you > > Pat Iurato > > Nevada > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 27, 2000 Report Share Posted December 27, 2000 Cathy, Thanks for your words of encouragement. I'm not giving up - just rearranging my plan of attack. Tarri in Missouri MGB 09-29-00 329/259 My Insurance Update > > > > > > > Well my good friends, I have some news on the insurance front. > > > Evidently I made a big enough stink to the insurance company about > > > the biases the insurance doctor has against bariatric surgery. They > > > called me today and are now sending my complete medical history to > > > Utah for an independent evaluation by a bariatric surgeon there. Dont > > > know if this is a good thing or not but its still another step before > > > I do an appeal. I am assuming they took back the denial after I sent > > > them even more nutritional information. I still have an appeal date > > > set and am not going to change that for now, unless they tell me > > > different. I am just hoping and praying they dont tell me I have to > > > have it done in Utah now. Ok ok now I need to settle down and stop > > > thinking this way, right?? Let me know what you think I am most > > > interested in the opinions of my MGB friends. > > > Love to all of you > > > Pat Iurato > > > Nevada > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 27, 2000 Report Share Posted December 27, 2000 Cathy, Thanks for your words of encouragement. I'm not giving up - just rearranging my plan of attack. Tarri in Missouri MGB 09-29-00 329/259 My Insurance Update > > > > > > > Well my good friends, I have some news on the insurance front. > > > Evidently I made a big enough stink to the insurance company about > > > the biases the insurance doctor has against bariatric surgery. They > > > called me today and are now sending my complete medical history to > > > Utah for an independent evaluation by a bariatric surgeon there. Dont > > > know if this is a good thing or not but its still another step before > > > I do an appeal. I am assuming they took back the denial after I sent > > > them even more nutritional information. I still have an appeal date > > > set and am not going to change that for now, unless they tell me > > > different. I am just hoping and praying they dont tell me I have to > > > have it done in Utah now. Ok ok now I need to settle down and stop > > > thinking this way, right?? Let me know what you think I am most > > > interested in the opinions of my MGB friends. > > > Love to all of you > > > Pat Iurato > > > Nevada > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 27, 2000 Report Share Posted December 27, 2000 Dear Pat, Thanks for your word of encouragement. I'm waiting for the actual written letter upholding the denial. I also still need to contact the Missouri Insurance Commission and let them know they were provided with a false medical necessity outline. With the holidays I just haven't had time and didn't want to be more depressed while trying to celebrate with my family. My medical necessities (that I met with their " old form " ) were 1. over 100 pounds overweight 2. BMI in excess of 30 3. profound depression and poor self esteem 4. sleep apnea. I have more but didn't present them there thinking I had met their criteria. I really don't want to litigate but have not made a decision on that yet. How are you doing. We got more snow this week (on Christmas Day, no less) with more on the way Thursday/Friday. Are you sure I can't FedEx you a snowball? Tarri in Missouri MGB 09-29-00 329/259 Re: My Insurance Update > Oh Tari, I can relate so well to those stall tactics. I believe they think if > they continue to stall they will wear us down. Not this time!!!!!!!! They did > all of this to me 2 years ago and I gave up but I wont let them get me again. > Keep fighting them as long as it takes. I cant believe they change the > criteria right in the middle of your battle, how convient!! What were your > medical necessities? Are you gonna hire an attorney? > Keep in touch > Pat > Nevada > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 27, 2000 Report Share Posted December 27, 2000 Dear Pat, Thanks for your word of encouragement. I'm waiting for the actual written letter upholding the denial. I also still need to contact the Missouri Insurance Commission and let them know they were provided with a false medical necessity outline. With the holidays I just haven't had time and didn't want to be more depressed while trying to celebrate with my family. My medical necessities (that I met with their " old form " ) were 1. over 100 pounds overweight 2. BMI in excess of 30 3. profound depression and poor self esteem 4. sleep apnea. I have more but didn't present them there thinking I had met their criteria. I really don't want to litigate but have not made a decision on that yet. How are you doing. We got more snow this week (on Christmas Day, no less) with more on the way Thursday/Friday. Are you sure I can't FedEx you a snowball? Tarri in Missouri MGB 09-29-00 329/259 Re: My Insurance Update > Oh Tari, I can relate so well to those stall tactics. I believe they think if > they continue to stall they will wear us down. Not this time!!!!!!!! They did > all of this to me 2 years ago and I gave up but I wont let them get me again. > Keep fighting them as long as it takes. I cant believe they change the > criteria right in the middle of your battle, how convient!! What were your > medical necessities? Are you gonna hire an attorney? > Keep in touch > Pat > Nevada > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 27, 2000 Report Share Posted December 27, 2000 Send those snowballs, c'mon I am waiting for them, lol. Maybe you should ice them up real hard and throw them at the ignorant insurance people who keep denying you. Tell them you want a down right actual snowball war,. LOL imagine that!!!!! How were your holidays? Mine were hectic but fun and of course as you know I am still waiting to hear from the insurance company. I am so impatient, I just want an answer so that I can make plans. Let me know how you do with your insurance company when the time comes. I have you in my prayers. Pat Nevada hopeful Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 27, 2000 Report Share Posted December 27, 2000 Send those snowballs, c'mon I am waiting for them, lol. Maybe you should ice them up real hard and throw them at the ignorant insurance people who keep denying you. Tell them you want a down right actual snowball war,. LOL imagine that!!!!! How were your holidays? Mine were hectic but fun and of course as you know I am still waiting to hear from the insurance company. I am so impatient, I just want an answer so that I can make plans. Let me know how you do with your insurance company when the time comes. I have you in my prayers. Pat Nevada hopeful Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 28, 2000 Report Share Posted December 28, 2000 Hi Pat, my name is and I'm considering the MGB. I'd appreciate it if you could tell me about all the steps leading up to it. Especially time frames. Thanks, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 28, 2000 Report Share Posted December 28, 2000 Hi Pat, my name is and I'm considering the MGB. I'd appreciate it if you could tell me about all the steps leading up to it. Especially time frames. Thanks, Quote Link to comment Share on other sites More sharing options...
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