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 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...
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