Guest guest Posted September 18, 2001 Report Share Posted September 18, 2001 I called my PCP's office today to see if my doc has sent in the revised Letter of Medical Necessity to Pacificare. (I had copied a sample letter and attached Chris' excellent Aetna appeal letter - thanks Chris!) Two weeks ago, I walked the letter to them and I've been waiting since. I spoke with the receptionist and she said the doc hasn't done it yet. I told her how much I needed it because I have a 10-10 app't with Dr. Rabkin. I have to bring in test results to Dr R and I'm not going to get them paid for unless Pacificare approves the consultation. She said she would tell him and then said she had read through some of the papers and is interested in the surgery for herself! She has a friend who had the RNY and, according to her, " she is a mess physically " . She said there's no way she would want the RNY and didn't understand why Pacificare would approve the RNY when the much better DS is available. (Join the club!) So I have her on my side and she said she's going to push him to do it. It's so frustrating because all I need is for my PCP to copy the letter onto his letterhead and sign it... then give me a physical and order the necessary tests. That's it! Grrrrrrr.... BTW, I've been thinking about the monthly meeting last month - does anyone know who the patient was that came down from her hospital room? I want to send her an email if she's on the list but I don't know her name. ===== Dee Waiting for Ins. Co. Approval 313/Want to be 165 __________________________________________________ Terrorist Attacks on U.S. - How can you help? Donate cash, emergency relief information http://dailynews.yahoo.com/fc/US/Emergency_Information/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 18, 2001 Report Share Posted September 18, 2001 Dee, I do not know which state you are in but I had PacifiCare of Washington cover my DS and subsequent surgeries. All totaled came to $100,000.00 I talked to United Health Network ( they are the ones who make the decisions) and they told me as of January 2001 PacifiCare was covering Global Bariatric Surgery. It will happen for you. Keep the faith. Angels hover ever near, DS 4/11/01 Bowel obstruction 4/21/01 Dr Deveney @ OHSU Starting wt 282, BMI 47 Current wt 222, BMI 37 Still Waiting... > I called my PCP's office today to see if my doc has > sent in the revised Letter of Medical Necessity to > Pacificare. (I had copied a sample letter and > attached Chris' excellent Aetna appeal letter - thanks > Chris!) Two weeks ago, I walked the letter to them > and I've been waiting since. > > I spoke with the receptionist and she said the doc > hasn't done it yet. I told her how much I needed it > because I have a 10-10 app't with Dr. Rabkin. I have > to bring in test results to Dr R and I'm not going to > get them paid for unless Pacificare approves the > consultation. > > She said she would tell him and then said she had read > through some of the papers and is interested in the > surgery for herself! She has a friend who had the RNY > and, according to her, " she is a mess physically " . > She said there's no way she would want the RNY and > didn't understand why Pacificare would approve the RNY > when the much better DS is available. (Join the > club!) > > So I have her on my side and she said she's going to > push him to do it. > > It's so frustrating because all I need is for my PCP > to copy the letter onto his letterhead and sign it... > then give me a physical and order the necessary > tests. That's it! Grrrrrrr.... > > BTW, I've been thinking about the monthly meeting last > month - does anyone know who the patient was that came > down from her hospital room? I want to send her an > email if she's on the list but I don't know her name. > > > > > > ===== > Dee > Waiting for Ins. Co. Approval > 313/Want to be 165 > > __________________________________________________ > Terrorist Attacks on U.S. - How can you help? > Donate cash, emergency relief information > http://dailynews.yahoo.com/fc/US/Emergency_Information/ > > ---------------------------------------------------------------------- > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.