Guest guest Posted September 28, 2000 Report Share Posted September 28, 2000 After almost 2 months of studing, researching, writing, and tests I got an approval from Dr. Rutledge for the surgery yesterday. I was so happy. Having talked to at least 10 different people from my insurance Co- including my case manager- all agreed that I met the criteria for the surgery - I never considered a turn down- Infact I had begun the Airline ticket search. My Birthday is Oct. 6th and I couldn't wait to have a re-birth. This morning My insurance - Great West (OneHealth care) PPO - called and said that the dr. who reviews and makes the decision turned me down becasue " Laproscopy is not the " standard " for this operation " I was shocked - So are they saying on other words that they want to pay an extra 30,000.???? I have cost them that much just this year with all my problems and last year was double.- They said I can appeal- but my first reaction was to just be numb- now I am mad. My husband and parents are literally " Devestated " You'd think I had just gotten a death penalty - which is how they look at me at this point. My mom was crying in her office- hoping I wouldn't see- but I know better. Well, I am NOT going to die! I wrote to Dr. Rutledge about this and am waiting to hear from him. I am soooooo ready - and it sure wan't easy for me to get to this point. Not giving up yet! Debby (In Arizona) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 28, 2000 Report Share Posted September 28, 2000 Hi, My b-day is the same! Please don't get discouraged. Start with the appeal letter on the website and give them the manual and the paper. I know its discouraging, but it is not the end! Laurie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 28, 2000 Report Share Posted September 28, 2000 Hi, My birthday is Oct. 3rd. Debby happy birthday.... and good luck with your insurance company..Trudy Broken Heart In Arizona After almost 2 months of studing, researching, writing, and tests I got an approval from Dr. Rutledge for the surgery yesterday. I was so happy. Having talked to at least 10 different people from my insurance Co- including my case manager- all agreed that I met the criteria for the surgery - I never considered a turn down- Infact I had begun the Airline ticket search. My Birthday is Oct. 6th and I couldn't wait to have a re-birth. This morning My insurance - Great West (OneHealth care) PPO - called and said that the dr. who reviews and makes the decision turned me down becasue " Laproscopy is not the " standard " for this operation " I was shocked - So are they saying on other words that they want to pay an extra 30,000.???? I have cost them that much just this year with all my problems and last year was double.- They said I can appeal- but my first reaction was to just be numb- now I am mad. My husband and parents are literally " Devestated " You'd think I had just gotten a death penalty - which is how they look at me at this point. My mom was crying in her office- hoping I wouldn't see- but I know better. Well, I am NOT going to die! I wrote to Dr. Rutledge about this and am waiting to hear from him. I am soooooo ready - and it sure wan't easy for me to get to this point. Not giving up yet! Debby (In Arizona) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 28, 2000 Report Share Posted September 28, 2000 Hey Laurie, Happy Birthday to you too, Have you had the surgery already? I can't wait, its been 6 months trying to get the insurance to pay, now I'm self-paying and I can't wait to get an appointment for surgery.. Trudy Re: Broken Heart In Arizona Hi, My b-day is the same! Please don't get discouraged. Start with the appeal letter on the website and give them the manual and the paper. I know its discouraging, but it is not the end! Laurie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 28, 2000 Report Share Posted September 28, 2000 Hey Debbie: That's the attitude! Don't give up and get royally pissed! Put your stuff together, write a great letter (lots of folks have sample letters you can use) and go get em. How stupid that they'd rather you had a huge incision. Best wishes. You'll get there. You deserve this! Flo in land > ** Original Subject: RE: Broken Heart In Arizona > ** > ** Original Date: Thu, 28 Sep 2000 17:08:01 -0600 > ** Original Message follows... > > After almost 2 months of studing, researching, writing, and tests I got an > approval from Dr. Rutledge for the surgery yesterday. I was so happy. > Having talked to at least 10 different people from my insurance Co- including > my case manager- all agreed that I met the criteria for the surgery - I never > considered a turn down- Infact I had begun the Airline ticket search. My > Birthday is Oct. 6th and I couldn't wait to have a re-birth. > This morning My insurance - Great West (OneHealth care) PPO - called and said > that the dr. who reviews and makes the decision turned me down becasue > " Laproscopy is not the " standard " for this operation " I was shocked - So are > they saying on other words that they want to pay an extra 30,000.???? I have > cost them that much just this year with all my problems and last year was > double.- They said I can appeal- but my first reaction was to just be numb- > now I am mad. My husband and parents are literally " Devestated " You'd think > I had just gotten a death penalty - which is how they look at me at this > point. My mom was crying in her office- hoping I wouldn't see- but I know > better. Well, I am NOT going to die! I wrote to Dr. Rutledge about this and > am waiting to hear from him. I am soooooo ready - and it sure wan't easy for > me to get to this point. > Not giving up yet! > Debby (In Arizona) > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 28, 2000 Report Share Posted September 28, 2000 Thank you and to you too! Yes, I had my surgery 9 days ago and i am doing well. best Wishes for getting a date soon to you:) Laurie > Hey Laurie, Happy Birthday to you too, Have you had the surgery already? I can't wait, its been 6 months trying to get the insurance to pay, now I'm self-paying and I can't wait to get an appointment for surgery.. Trudy > Re: Broken Heart In Arizona > > > Hi, > > My b-day is the same! > > Please don't get discouraged. Start with the appeal letter on the > website and give them the manual and the paper. I know its > discouraging, but it is not the end! > > Laurie > > > Quote Link to comment Share on other sites More sharing options...
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