Guest guest Posted October 5, 2000 Report Share Posted October 5, 2000 Dear People of the List Who Have been Denied by Insurance Companies in DIRECT violation of the Federal National Guidelines: Something is " rising " up in me about this injustice. I am convinced that this surgery (and those like it) will become as commonly accepted as any other disease course of therapy. I too am in the " denial " loop, but here in Ohio, House Bill 4 passed and went into effect May 1, 2000. If the consumer disagrees with the decision of the Insurer, it has to go to the state and passed on to an Independent External Review Organization. This process is not " supposed " to be influenced by the insurer in any way but we'll see. I don't have the time at present, but when I get a break from my current projects, I am going to start a grass roots effort to fight insurance companies that deny coverage when it is medically necessary. I want to provide a web site about those being denied. I believe campaign letters to there " largest " employer accounts will result in some action. I think that the human resource coordinators and those " selecting " the plans can make a difference. I'm not going to take this and no obese person should have to beg for MEDICALLY NECESSARY CARE. They are counting on us backing down and I feel like locking arms and singing " We Shall Overcome " . > The good news: Dr. R has approved me for surgery. I'm trying to get > a date during Turkey week. > > The bad news: To my total lack of surprise, BC/BS of Alabama has > denied me, as they did when I tried for R-en-Y surgery, claiming that > the procedure is not medically necessary unless I'm twice my ideal > weight for two years. Totally contrary to NIH guidelines, but I > don't have it in me to fight them again as I did (unsuccessfully) > over the R-en-y surgery. I think I'd win if I litigated, but since > my employer (Univ. of Ala.) self-insures and uses BC/BS only as a > claims administrator, and I'm not yet tenured, I think it would be > unwise. > > So, self-pay. But the good news trumps the bad! > > Regards to all. > > Jon in Tuscaloosa Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 6, 2000 Report Share Posted October 6, 2000 Dear , Thank you. in CO > Dear People of the List Who Have been Denied by Insurance Companies > in DIRECT violation of the Federal National Guidelines: > > Something is " rising " up in me about this injustice. I am convinced > that this surgery (and those like it) will become as commonly > accepted as any other disease course of therapy. I too am in > the " denial " loop, but here in Ohio, House Bill 4 passed and went > into effect May 1, 2000. If the consumer disagrees with the decision Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 6, 2000 Report Share Posted October 6, 2000 , I'm 100% with you, girl. Let's lock arms, via the net, and let the insurance industry know that we fat folks aren't LESS of anything: not importance, nor intelligence, nor strength, nor passion, nor ability to fight for ourselves and for what is right and necessary! You go girl, i'm with you . PhillyJude Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 7, 2000 Report Share Posted October 7, 2000 Thank you Jon- I somehow knew something could be done to stop this bureaucratic quagmire..Thanks for using those brain cells!!! I'll be looking for that site. Regina in Charlotte Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2000 Report Share Posted October 8, 2000 Thanks for your message! When you decide what you want to do on this score, please contact me and tell me how I can help! Best, Jon in Tuscaloosa 5'6 " , 270, BMI 43 Doin' the dance 11/22 > > The good news: Dr. R has approved me for surgery. I'm trying to > get > > a date during Turkey week. > > > > The bad news: To my total lack of surprise, BC/BS of Alabama has > > denied me, as they did when I tried for R-en-Y surgery, claiming > that > > the procedure is not medically necessary unless I'm twice my ideal > > weight for two years. Totally contrary to NIH guidelines, but I > > don't have it in me to fight them again as I did (unsuccessfully) > > over the R-en-y surgery. I think I'd win if I litigated, but since > > my employer (Univ. of Ala.) self-insures and uses BC/BS only as a > > claims administrator, and I'm not yet tenured, I think it would be > > unwise. > > > > So, self-pay. But the good news trumps the bad! > > > > Regards to all. > > > > Jon in Tuscaloosa Quote Link to comment Share on other sites More sharing options...
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