Re: Re: ins.

[Guest guest]

At 20:23 -0400 8/29/01, dwkteach@... sat down at the keyboard and wrote:

>So self insured I

>think can sometimes be a good thing because it isn't coming out of their

>pocket (BC/BS). In fact I think their fee is based on 1% of actual bills, so

>they really make more by approving!!!

I sure wish that were the case in TN! My DH's company is self-insured

and adminstered by BC/BSofTN; you'd think every approval was COSTING

them money instead of earning it. I am fighting my first denial even

now, using parts of Hull's admirable letter.

--stella

[Guest guest]

Carole

I had to wait 90 days before my insurance went into effect.I

initially wanted the RNY simply because I wasn't aware of the DS, but

fortunetly I couldn't find a RNY DR in Michigan. We have bariatric treatment

centers who will not touch me as a revision and only do the RNY and we had

another DR who said if you had BC/BS you had to show 18 months of documented

physician supervised diets, or BC wouldn't even give it a second

thought.That was so far from being right, my BC/BS PPO didn't even require

pre-authorization, you just had the surgery and submitted the bill. They

paid all but $900.00 of it too!!

So needless to say I spent 3 months trying to find a RNY DR. By the

time I gathered all my previous medical records (i was a revision from a

failed VBG), got my first consult appointment ( you had to attend a support

group meeting first),an additional 3 months had passed. I told the company I

was having major surgery, they had no problem with it.

Renae

2/27/01 245lbs

8/30/01 177lbs and smiling, walking with shoulders back and head held high

for a change!!!

>From: MsMystic1@...

>Reply-To: duodenalswitch

>To: duodenalswitch

>Subject: Re: ins.

>Date: Wed, 29 Aug 2001 18:46:10 EDT

>

>In a message dated 8/29/01 9:06:10 AM Eastern Daylight Time,

>duodenalswitch writes:

>

><< and went to work

> for them. I had the surgery as soon as I could after it went into effect.

> >>

>

>How long did you have to wait? I am due to get insurance at my company in

>about a month and wonder how long do I have to wait to start the ball

>rolling.

>

>Also - how did you explain your time off work to the new job?

>

> Funny how when you want this surgery one of the major questions when

>looking

>for a job is " what kind of insurance do you have? " and if the answer is

> " self-insured, " or something else that we know won't cover it, its thanks

>but

>no thanks to the job! Carole

>

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