Cranky In Arizona

[Guest guest]

Hi Guys,

Debby in AZ here - and need some advice - My insurance - Great West

(ONeHealth) a PPO - turned me down BECAUSE " The laporscopic procedure is NOT

the " Standard " procedure " for WLS - duhhhhhhh - I thougt that was the point

of the huge Letter we sent them- guess they want to pay an xtra 30,000 to cut

me up one end and down the other....? Anyway - I read all the appeal letters

and didn't think any of them replied to this type of resistance - then I

wrote two letters to Dr. R. who finally answered me with a one liner " an

appeal is usually the next step " Boy was I mad over that one. It really made

me feel like he didn't care OR that he is just " TOO " busy- which is also a

little bit of a concern for me - so after 2 days of pouting and trying to

talk myself into giving up- I have failed - I NEED THIS SURGERY SO - I am

coming to you - How would you respond by way of appeal to them - keep in mind

- they aren't saying I don't qualify and they aren't saying I don't need it -

they are resisting this particular procedure.

Thanks in advance for any help you may have.

Debby (in Arizona)