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Re: PATIENTS FROM CT-PROBLEMS W/INSURANCE

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Hello W--

I am from Connecticut, I live in Rocky Hill, just south of Hartford.

I had the MGB on 7/20--just over three weeks ago. I have Anthem Blue

Cross, the " blue care " plan, which is an HMO-type plan with very

strict " out of network " prohibitions. They denied me the first time

on the basis of " comparable surgery " being available in-network

(referring to the open RNY performed by Dr. Barba in Hartford and Dr.

Reinholdt in New Haven.) I wrote a letter requesting reconsideration

(the pre-appeal step), and I was lucky enough to have established a

good relationship over the phone with a lady there who walked my

reconsidation request through the process.

My reconsideation " request " (actually, a very long in-depth letter

comparing Dr. R's surgery with the brochure available from Dr.

Reinholdt's office in New Haven, concluding that the RNY and the MGB

aren't even remotely " comparable " ) was approved within just a few

days--On July 5th, actually, and I was able to schedule the surgery

for July 20th. All in all, it went pretty smoothly with the

insurance

company, despite their initial reticence.

Now, at 3 weeks post-op, I have lost almost 20 pounds, no

complications whatsoever, no regrets.

Hope this helps, let me know if you have any more

questions--alexa@....

--a

> I WOULD LIKE TO KNOW IF ANYONE FROM CT, HAD THE SURGERY HAVE

PROBLEMS

> WITH THE INSURANCE COMPANY CONSENTING TO LET THEM HAVE THE SURGERY

NC?

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