Re: **HELP**I need some good advice

[Guest guest]

Hello all, This is the post that I pray none of you have to ever

write,and one I regret you may.I am in SHOCK and need help.Especially if

you have gotten a recent approval from BCBS/NC.They turned me down.I cannot

go see the corporate administator,I am she.I know that I qualify per my

policy.I am 100++ lbs over,my BMI is 48 and I sent them FOUR(yes 4)sets of

hospital records,where I successfully lost weight(obviously I found

it)Hey,do you think that is why it keeps coming back,it thinks it's

lost?Anyway,I know I have the worst timing on the planet.So,someone please

help!The letter says I was turned down due to 'Ltd clinical information,and

for further reconsideration they must have a copy of the physical exam

performed at DrR's clinic appt'.It goes on to say that it can be corrected

with an informal process by DrR with a phone call or letter.I KNOW this must

have happened to someone else,please fill me with your wise experience.Has

he done this for anyone?DrR if you see this and can FIX IT,I would surely

appreciate it. Janet Whitaker

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[Guest guest]

Janet,

If I remember correctly, Gloria Dean a/k/a Little Red, had just jumped through

all

these hoops with BCBS/NC. They are being pesky about Dr. R seeing you for an

actual

physical, and aren't happy enough with the clinic visit. Gloria just had her

surgery

this Monday, but I'm sure she could give you some tips and advice on how to

handle

this when she is up to it. Dana Tart is another pre-op that's having trouble

with

BCBS/NC. Don't give up, Janet!

Tricia in IL

Janet Whitaker wrote:

> BCBS/NC.They turned me down. The letter says I was turned down due to 'Ltd

clinical information,and

> for further reconsideration they must have a copy of the physical exam

> performed at DrR's clinic appt'.It goes on to say that it can be corrected

> with an informal process by DrR with a phone call or letter.I KNOW this must

> have happened to someone else,please fill me with your wise experience.Has

> he done this for anyone??

[Guest guest]

Janet

I am having a hard time with BCBS as well. They have denied me twice and

yesterday my claim was to go up for Formal Appeal before a special

committee. I STILL haven't heard a word. I left a message for my case

worker this morning and I havn't heard back form her and don't really expect

to.

I am still dealing witht the deaaaath of my friend and my son Ryker's

teacher- I can't take much more.

If you want to give mea call and talk about what you are going through the

best time to catch me is between 2;30 and 5;30 at work or

after 6 at home

Call I would love to compare notes

Dana

Re: **HELP**I need some good advice

> Hello all, This is the post that I pray none of you have to ever

> write,and one I regret you may.I am in SHOCK and need help.Especially if

> you have gotten a recent approval from BCBS/NC.They turned me down.I

cannot

> go see the corporate administator,I am she.I know that I qualify per my

> policy.I am 100++ lbs over,my BMI is 48 and I sent them FOUR(yes 4)sets of

> hospital records,where I successfully lost weight(obviously I found

> it)Hey,do you think that is why it keeps coming back,it thinks it's

> lost?Anyway,I know I have the worst timing on the planet.So,someone please

> help!The letter says I was turned down due to 'Ltd clinical

information,and

> for further reconsideration they must have a copy of the physical exam

> performed at DrR's clinic appt'.It goes on to say that it can be corrected

> with an informal process by DrR with a phone call or letter.I KNOW this

must

> have happened to someone else,please fill me with your wise experience.Has

> he done this for anyone?DrR if you see this and can FIX IT,I would surely

> appreciate it. Janet Whitaker

> _________________________________________________________________________

> Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.

>

> Share information about yourself, create your own public profile at

> http://profiles.msn.com.

>

>

>