Guest guest Posted August 30, 2001 Report Share Posted August 30, 2001 Hey Dee, In a former life, before childbirth over 20 years ago I worked for .........uuuummmmmm.....{Blue Cross}(whisper)...as a claims processor...just don't tell anyone!!! Besides, as employees, we can only do what the company will let us do!! And not all underwriters are bad!! There are laws and such that they have to follow, too. Just like some nurses and doctors are on burn out and need to get out of the business of healthcare...so do some of the " insurance companies " !! HAAAA! Course, if I don't overcome my " criteria " for surgery I may be changing my mind!!! The criteria calls for medically supervised diet 3 of the last 5 years. THEN, they want weekly medically supervised diet visits for 6 months of the last year!! I've been morbidly obese since I was 20 (about 65 pounds overweight at 18)and super morbid obese since about 26 or 28 and I am now 43!! I gave up the " medically supervised diet game ALONG TIME AGO!! This " criteria " is bull or for someone who just got fat in the last 5 years....they require that you be 200% over your highest insurance chart weight for no less than the last 5 years. But, hey girl, we'll make it!! Hugs, Jerry, southern gal from Louisiana > >Reply-To: duodenalswitch >To: duodenalswitch >Subject: Re: Denial Notice >Date: Thu, 30 Aug 2001 14:04:12 -0700 (PDT) > >Jerry, I welcome the policy! I don't care if it's a >book or not - LOL > >Actually, in my previous life (before becoming injured >on the job), I was an insurance underwriter. No, I >did NOT work for health care so please do not flame >me! I am/was a commercial property, general >liability, and auto underwriter. So reading a policy >doesn't scare me! > >dee > >--- Jerry Cook wrote: > > You are within your rights to demand a copy of your > > policy! You usually > > will get a BOOK with ALOT of " legal terms " but you > > can make out what the > > limits and exclusions are. Sometimes, however, you > > are also able to find > > loopholes!! Make em give you a copy of your policy, > > a policy booklet or > > something...DON'T LET EM SEE YOU SWEAT!! > > HUGS TO A FELLOW WLS SISTER > > JERRY, Southern gal from Louisiana > > > > > > > > > >Reply-To: duodenalswitch > > >To: DS PacificLap > > <DS_PacificLaparoscopy >, DS Switch > > ><duodenalswitch > > > >Subject: Denial Notice > > >Date: Thu, 30 Aug 2001 08:14:57 -0700 (PDT) > > > > > >Ohmygosh, thank you all so much for the > > encouranging > > >posts about my having doubts regarding the DS. I > > was > > >having a weak moment, doubting myself, and there > > you > > >were to pick me up. Dammit, this is not a cosmetic > > >type surgery and we do deserve the best - not the > > >cheapest - way to lose weight. > > > > > >By the way, I received a note from Pacificare that > > >says: Intestinal bypass surgery is not a covered > > >benefit on your plan. > > > > > >I had asked to see a copy of the policy itself that > > >showed that and was told all they can do is send a > > >letter. I want to see the actual policy language - > > is > > >that asking for too much? > > > > > >So, can I still fight this if it's correct that > > >intestinal bypass isn't covered? > > > > > >Thanks again, > > > > > >===== > > >Dee > > >Waiting for Ins. Co. Approval > > >313/Want to be 165 > > > > > >__________________________________________________ > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2001 Report Share Posted August 30, 2001 Dear Dee, I am a credentialed medical insurance mediator who is getting pretty dang good at helping ds'ers fight for surgery. If I can help you let me know!!!! Deanna 300lbs bmi 50 day of surgery 02-15-01 197lbs. bmi 31 as I sit here now! THANKS GOD !!!! http://www.duodenalswitch.com/Patients/Deanna/deanna.html Denial Notice > > >Date: Thu, 30 Aug 2001 08:14:57 -0700 (PDT) > > > > > >Ohmygosh, thank you all so much for the > > encouranging > > >posts about my having doubts regarding the DS. I > > was > > >having a weak moment, doubting myself, and there > > you > > >were to pick me up. Dammit, this is not a cosmetic > > >type surgery and we do deserve the best - not the > > >cheapest - way to lose weight. > > > > > >By the way, I received a note from Pacificare that > > >says: Intestinal bypass surgery is not a covered > > >benefit on your plan. > > > > > >I had asked to see a copy of the policy itself that > > >showed that and was told all they can do is send a > > >letter. I want to see the actual policy language - > > is > > >that asking for too much? > > > > > >So, can I still fight this if it's correct that > > >intestinal bypass isn't covered? > > > > > >Thanks again, > > > > > >===== > > >Dee > > >Waiting for Ins. Co. Approval > > >313/Want to be 165 > > > > > >__________________________________________________ > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2001 Report Share Posted August 30, 2001 --- Jerry Cook wrote: Hey Dee, In a former life, before childbirth over 20 years ago I worked for ........uuuummmmmm.....{Blue Cross}(whisper)...as a claims processor...just don't tell anyone!!! ******* Do ya think anyone saw our posts? hehehe Well, I don't feel so bad, at least I didn't work in claims! (Just kidding!) Sometimes I'd rather say I'm a used car saleswoman or life insurance saleswoman than work for an insurance company! LOL As for the hoops we must go through, it's so ridiculous. Like we haven't already tried every diet out there already! What REALLY gets me are the WLS doctors who want us to lose 10% of our body weight prior to WLS. Why punish us one last time before surgery? dee ===== Dee Waiting for Ins. Co. Approval 313/Want to be 165 __________________________________________________ Quote Link to comment Share on other sites More sharing options...
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