want some feedback,please!

[Guest guest]

Dear Leilla, It's scary when one person, regardless of who, has that much

control over your (or MY) life, isn't it? The woman in your company who will

do the research and who will present the opinion as to whether or not WLS

should be covered is clearly not in your corner. I say, do the research for

her. Get everything you can off of our web site, and the Obesityhelp.com

site, and American Association of Bariatric Surgeons site, and wherever else

you can, and print it out for her. Get this weeks NYTimes article. No one

is going to care about the completeness of the research like you would. Dr.

R can probably offer more info, and he has an " appeal letter " which in this

case might be used pre-emptively (before you've been refused.) Think about

it, and let me know if I can help. I have the NYTimes article, if you need

it. Don't even let the thought occur to you that she will not add WLS to

covered procedures, once she sees the research you've done. Let her know,

too, that there is a new sub-specialty being created by certain law firms

called : obesity advocacy.

That will tell her that she better not refuse. Get everyhting you can that

states absolutely that with a BMI >40, it is medically necessary. Tell her

how wise she will be considered when they realize all the diabetes, heart,

hypertension, stroke, arthritis and sleep apnea medicines and procedures she

will be eliminating for them!

Hit her with all your barrles loaded and ready. How could she possibly

refuse. And if she does, OH Baby, we go to plan B. You're at the right

place. She is not going to take your quality of life, no way. We won't let

that happen. You got work to do, girl. Go get em!! PhillyJude

[Guest guest]

hi friends, this is leilla from claremont, nc. i don't post often,

buti am in need of some feedback. i have yet to be approved by my

insurance for this surgery...i work at a hospital and we are self-

insured, this surgery is an exclusion on our policy. well, i handed

in the letter from dr. r, along with a letter from myself explaining

why i must have this surgery and how i hate my life as it is, about 2

weeks ago. after 1 week of not getting any type of response, i e-

mailed the director of human resources to check on the status of my

letters. she e-mailed me back saying that the letters were in a

folder to be read the week of the 16th, and at that time, it would

not be a yes or no, but would be a question of if it should be added

to our insurance policy, and if so, it would be researched. well, i

got back to her, wanting to know who is to do the research and how

long this will take. it turns out that she would begin the research

(not a board of docs), and if she decides to add it to our policy,

that would happen in february. I want to be positive, but i was

feeling negative vibes from this woman. sorry to be so long winded,

but i realize that this group is here to offer support to one

another, and friends, that is what i am in need of at this time. how

would some of you take this response? any experienced with appeals

would be appreciated also.

another thing...has anyone heard from cathy from lenoir...haven't

read her posts for sometime now and i miss her encouraging words.

leilla from claremont nc

[Guest guest]

thanks so much for your reply, i feel better already. just knowing

that you have someone on your side makes you feel so much stronger. I

have already given her some info that i printed off of a

site " obesityhelp.com " which listed insurance companies in our state

(north carolina) which do cover this surgery. i do want to give her

all the information that i can to help her realize that this surgery

is necessary, but i don't know if i should do this immediately, or

give her an opportunity to read dr r's letter first. i definately

have comorbidities to reason having the surgery; sleep apnea,

hypertension to name a few, and a bmi of 53. about the nytimes

article; i would love to have a copy. thanks dear friend.

leilla from claremont nc-

-- In MiniGastricBypass (AT) egroups (DOT) com, Judyh1022@a... wrote:

> Dear Leilla, It's scary when one person, regardless of who, has

that much

> control over your (or MY) life, isn't it? The woman in your

company who will

> do the research and who will present the opinion as to whether or

not WLS

> should be covered is clearly not in your corner. I say, do the

research for

> her. Get everything you can off of our web site, and the

Obesityhelp.com

> site, and American Association of Bariatric Surgeons site, and

wherever else

> you can, and print it out for her. Get this weeks NYTimes

article. No one

> is going to care about the completeness of the research like you

would. Dr.

> R can probably offer more info, and he has an " appeal letter " which

in this

> case might be used pre-emptively (before you've been refused.)

Think about

> it, and let me know if I can help. I have the NYTimes article, if

you need

> it. Don't even let the thought occur to you that she will not add

WLS to

> covered procedures, once she sees the research you've done. Let

her know,

> too, that there is a new sub-specialty being created by certain law

firms

> called : obesity advocacy.

> That will tell her that she better not refuse. Get everyhting you

can that

> states absolutely that with a BMI >40, it is medically necessary.

Tell her

> how wise she will be considered when they realize all the diabetes,

heart,

> hypertension, stroke, arthritis and sleep apnea medicines and

procedures she

> will be eliminating for them!

> Hit her with all your barrles loaded and ready. How could she

possibly

> refuse. And if she does, OH Baby, we go to plan B. You're at the

right

> place. She is not going to take your quality of life, no way. We

won't let

> that happen. You got work to do, girl. Go get em!!

PhillyJude