Guest guest Posted August 12, 2000 Report Share Posted August 12, 2000 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? Quote Link to comment Share on other sites More sharing options...
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