Guest guest Posted August 8, 2000 Report Share Posted August 8, 2000 Hi all.... I got word a few days ago that my grievance review (stage just before a formal appeal) for approval had been denied. Their rational was that; a. my high blood pressure is under control with medication, and b. my sleep apnea, though documented, is under control with a CPAP machine. (which I don't even have YET) There is no mention of the other co-morbidities that I have documented in a statement from my PCP. (chronic fategue, urinary incontenence, edema, back/weight-bearing-joint pain, shortness of breath/dyspnea on exertion, decreased lung function tests) This has been typical, so far... the picking out of 1 or two treatable things, out of a lengthy list with many things that don't respond or can't be treated, and throwing it back at me as denied. This is so frustrating. so I'm starting, today, to keep a diary of EVERY thing I do and how/what I feel while doing them... including how long it takes me to recover, ect. How laborious and tedious. UGH!! someone also brought up the idea of writing to the insurance commission.... hmmm... I wonder if that would help? *shrug* Might not hurt. I'm also coung to assemble a table of costs... the MGB versus 2 years of my medicines, CPAP machine, and admissions to the hospital due to my asthma, based on the last couple years admissions. (My PCP has it in his notes that my obesity not only aggrivates, is most likely the reason for my breathing problems.) I'll speak their language, by showing that they will save $$. I'm going to take a couple day break to study for my final exam, and then get back on this matter. I know that ODS wants me to just roll over and go away... but they have made me good and pissed off, a mistake for sure. I'll litigate if they push me to it. But fortunately I know that I will be having the MGB sooner or later. I got the good news that my packet was approved. WHOOPIE! I just have to follow this whole insurance ordeal to it's conclusion... whatever that may be. Licking my wounds... getting good and mad... (God help ODS. *grin*) Jenn Brown Vancouver, WA Waiting to cross, but has ODS in her way ________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com Quote Link to comment Share on other sites More sharing options...
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