Re: Please help me with some numbers.

[Guest guest]

Hi . I'm sorry to hear about your denial, and even sorrier to

hear that you have an ERISA policy. ERISA is protected by law and

when they govern your policy, it can be difficult get an approval

without a fight because if they are sued by you, they only have to

pay what they would have had to pay if they had given you the care

that you need in the first place. Don't get me wrong, you can beat

them, but I'm sure that they will make you exaust your appeals

process before they do.

I was tested for sleep apnea in July and I spent the first night in

the hospital being tested without c-pap, and the second being tested

with c-pap. My insurance paid all of the sleep study even though they

had already denied me twice for WLS. The total bill came to 1500.00.

The c-pap machine was also paid for by my insurance company and cost

1200.00. You can also rent the c-pap on a monthly basis. I think that

the rental was 130.00 a month.

I have arthritis from several orthepedic injuries and the arthritis

shows up on MRI and possibly x-ray if I remember right. I took Daypro

which is a very expensive drug, but it was a Workers Comp injury so I

did not have to pay.

If you will send me an email, I have some information that may help

you understand what you need for your insurance company. I will have

to send it as an attachment, so I need your email address.

Stormy

> Hi everyone!

> Well my 1st appeal was rejected by BC/BS of SC from the Claims

Review

> Committee. The review of course was conduted in accordance with

the

> Employee Retirement Income Security Act of 1974(whatever the hell

> that is). I never realized 40 was retirement age.

> What I would like to do with the appeal I'm filing now is hit them

> with some numbers. What is the cost of testing in the sleep

centers?

> What is the cost of the CPAP machine with humidifier? Has anybody

> been through these diagnostics that can help?

> What about the cost of determining osteoarthritis? What kind of

> tests need to be done and how long does it take to get the

results?

> what kind of medications are used to treat or is this surgical too?

> How does a urologist determine whether you have stress related

> urinary incontinence? What test and where are they done? Do any

of

> these conditions require long term medications as treatment?

> Would it help to provide them with my parents medical reports and

the

> problems both of them have with blood pressure, sleep, ect.

> Anyone that has info, advice, or HELP.......

> Thanks,

> s

> Still trying to fight for the dance.

[Guest guest]

,

I would go a step further when corresponding with an insurance company

and have all mail certified. Make whoever receives the mail sigh for it

and get ou a rerceipt. Staple the receipt to a copy of each letter and

then let them say they did not get it. They can try but you have proof

and usually they want try to say they did not get it because they know

that you have the receipt. You can also do this with E-mail Good

luck Phyllis

One more trick, You may call the library and findout who the ceo is and

if male or female. Send a perfumed hand written letter marked personal

you may even put XoXo and the mail room usually will give it to him/her

unopened and you will at least get it to the right person.

s wrote:

> Hi everyone!

> Well my 1st appeal was rejected by BC/BS of SC from the Claims Review

> Committee. The review of course was conduted in accordance with the

> Employee Retirement Income Security Act of 1974(whatever the hell

> that is). I never realized 40 was retirement age.

> What I would like to do with the appeal I'm filing now is hit them

> with some numbers. What is the cost of testing in the sleep centers?

> What is the cost of the CPAP machine with humidifier? Has anybody

> been through these diagnostics that can help?

> What about the cost of determining osteoarthritis? What kind of

> tests need to be done and how long does it take to get the results?

> what kind of medications are used to treat or is this surgical too?

> How does a urologist determine whether you have stress related

> urinary incontinence? What test and where are they done? Do any of

> these conditions require long term medications as treatment?

> Would it help to provide them with my parents medical reports and the

> problems both of them have with blood pressure, sleep, ect.

> Anyone that has info, advice, or HELP.......

> Thanks,

> s

> Still trying to fight for the dance.

>

>