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Oh Sharon, I'm so sorry! APPEAL APPEAL APPEAL! Don't let them get

away with this! And go on antibiotics immediately so you can prove

to them the rashes are not just a fluke. Don't take this lying

down! You know as well as I do that these insurance companies deny

us, hoping that we'll just slink away and do nothing. I know it's

hard to have that fighting spirit right now but don't give up!

Please call me anytime if you need to talk.

Love you!

Tracey

> Hi all

> Well I just got off the phone with and UHC denied my

> reconstructive surgery. He said it was cosmetic.

> Sharon in Onyx

> ok, who is now crying, for heaven sake...this is ridiculous!

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Yay ! Whoo hoo!

Tracey

> In a message dated 5/2/2003 12:51:27 PM Central Daylight Time,

>

> See todays sig line....LOL<grinning big>

> in Bama

>

>

http://hometown.aol.com/mdl1031/myhomepage/profile.html

> Surgery- RNY to DS revision on12/6 -377.5

> 12/17 - 346.5 ( minus 31lbs)

> 01/15- 338.1 (minus 39.1lbs)

> 02/12-330.0 (minus 47.5 lbs)

> 04/06- 324.3 (minus 53.2 lbs)

> 05/02- 311 (minus 66.5 lbs)

>

>

>

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> Sharon,

>

> I'm collecting information for the day when I may need surgery for

> the extra skin.

>

> The web site shown below might help you in identifying the items

you

> need to document. You may also want to include this article in

your

> appeal. It shows the Recommended Criteria for Third-Party Payer

> Coverage for Treatment of Skin Redundancy Following Massive Weight

> Loss

>

>

http://www.plasticsurgery.org/medical_professionals/publications/Trea

t

> ment-of-Skin-Redundancy-Following-Massive-Weight-Loss.cfm

>

> Beverly in Antioch

> -DS on 3/10/2002

>

Hi Beverly

Thank you so much for the info. I printed off what I neede and am

going to add it to my appeal

great info,

thanks again

Sharon in Onyx

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  • 10 months later...
Guest guest

SHelly,

I am SO sorry to hear this. My brother is going through appeal right

now. He hired Walter Lindstrom (obesity related attorney)to do his

appeal for him - not sure why he chose to immediately take that

route but he did. What does exogenous obesity mean????

hugs, cindy lee

-- In , " Hattan "

<shelly@c...> wrote:

> Well, I just got a letter from my insurance. I've been denied

because I have

> a clause in the Exceptions area for " exogenous obesity " .

>

> Anybody on the list ever had to go through an appeal?

>

> Sincerely,

>

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SHelly,

I am SO sorry to hear this. My brother is going through appeal right

now. He hired Walter Lindstrom (obesity related attorney)to do his

appeal for him - not sure why he chose to immediately take that

route but he did. What does exogenous obesity mean????

hugs, cindy lee

-- In , " Hattan "

<shelly@c...> wrote:

> Well, I just got a letter from my insurance. I've been denied

because I have

> a clause in the Exceptions area for " exogenous obesity " .

>

> Anybody on the list ever had to go through an appeal?

>

> Sincerely,

>

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> Well, I just got a letter from my insurance. I've been denied

because I have

> a clause in the Exceptions area for " exogenous obesity " .

>

> Anybody on the list ever had to go through an appeal?

>

> Sincerely,

>

********

,

I'm so sorry to hear about your denial. PHCS was quick for my

approval - but, it must have been my original insurer (United Medical

Resources) that OK'd it. Who is your original insurer?

I've never heard of exogenous obesity! I looked it up on Webster's on

line dictionary; they give the health definition as something

that " developed or originated outside the organism. " This makes no

sense whatsoever!

There are numerous routes you can take. I think that the big D.S.

board group has some examples of appeal letters. I would

definitely try that. Also, did you talk to Arianna about her

suggestions? Then there is always hiring one of the attorneys that

specializes in weight loss surgery cases.

Don't get too down about it. Hang in there and fight 'm!

Melinda in NM

Dr. K

02/10/04

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On Fri, 12 Mar 2004 19:07:06 -0000, Melinda wrote:

> looked it up on Webster's on

>line dictionary; they give the health definition as something

>that " developed or originated outside the organism. " This makes no

>sense whatsoever!

Melinda,

I looked it up online. The definition said something about obesity related

to consuming more calories than are expended in normal activity. i.e.

You're overweight because you overeat. Typical uninformed insurance

position.

Jerry

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On Fri, 12 Mar 2004 19:07:06 -0000, Melinda wrote:

> looked it up on Webster's on

>line dictionary; they give the health definition as something

>that " developed or originated outside the organism. " This makes no

>sense whatsoever!

Melinda,

I looked it up online. The definition said something about obesity related

to consuming more calories than are expended in normal activity. i.e.

You're overweight because you overeat. Typical uninformed insurance

position.

Jerry

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> I looked it up online. The definition said something about

> obesity related to consuming more calories than are expended

> in normal activity. i.e.

> You're overweight because you overeat. Typical uninformed

> insurance position.

Well, if that's the true definition, it looks like I may be able to beat

this thing. :)

Keepin' optimistic!

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> I looked it up online. The definition said something about

> obesity related to consuming more calories than are expended

> in normal activity. i.e.

> You're overweight because you overeat. Typical uninformed

> insurance position.

Well, if that's the true definition, it looks like I may be able to beat

this thing. :)

Keepin' optimistic!

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> Well, I just got a letter from my insurance. I've been denied

because I have

> a clause in the Exceptions area for " exogenous obesity " .

,

Do you have hypothyroid disease? If so, that would be exogenous

obesity. Just a thought.

Laurie

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Guest guest

> Well, I just got a letter from my insurance. I've been denied

because I have

> a clause in the Exceptions area for " exogenous obesity " .

,

Do you have hypothyroid disease? If so, that would be exogenous

obesity. Just a thought.

Laurie

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No, I don't. Strange, huh.

> Re: Denied

>

>

> > Well, I just got a letter from my insurance. I've been denied

> because I have

> > a clause in the Exceptions area for " exogenous obesity " .

>

>

> ,

>

> Do you have hypothyroid disease? If so, that would be

> exogenous obesity. Just a thought.

>

> Laurie

>

>

>

>

>

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In a message dated 3/13/2004 12:36:19 AM Central Standard Time,

moobabies@... writes:

lol...that is like the best dumb-A$$ excuse to deny surgery I've

seen so far.

Jo

____________________________________

I SECOND THAT!!

in Bama

VBG 1982 (lost from 433lbs to 270's)

VBG -RNY1996 revision(Lost from 343 to 299)

RNY-DS revision Dec 2002 -down 130 lbs (377.7 to 247.2 and still going)

BMI 39.4...No longer Morbidly obese!

Homepage address- http://hometown.aol.com/mdl1031/myhomepage/profile.html

Many thanks to Dr. K willing to take on a 3rd timer....LOL

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>

> > I looked it up online. The definition said something about

> > obesity related to consuming more calories than are expended

> > in normal activity. i.e.

> > You're overweight because you overeat. Typical uninformed

> > insurance position.

Darn if that doesn't sound like a great reason to have a surgery

that decreases your stomach size and with malabsorption.

lol...that is like the best dumb-A$$ excuse to deny surgery I've

seen so far.

Jo

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In a message dated 3/12/2004 2:07:33 AM Pacific Standard Time,

shelly@... writes:

> Well, I just got a letter from my insurance. I've been denied because I

> have

> a clause in the Exceptions area for " exogenous obesity " .

>

> Anybody on the list ever had to go through an appeal?

>

> Sincerely,

>

Yep, yep, yep...four appeals...then just started all over again with Dr. K,

and got approved first time...there wheres and whyfores of insurance companies

will never cease to astound me.

Advice? Research, appeal, appeal, appeal.....

Hugs and blessings,

Ann

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  • 3 years later...

oh DEAR, Laurie!! I am so sorry that you now have to go at it all again!! WHY don't the docs check their essential info first!!?? I know they are overwhelmed too, but they should know this routine by heart by now!!

Power to you in your appeal et al !!

Jean

denied

My applying to OWCP Dept of Labor for Carpal Tunnel SUrgery is denied, because my drs explanation did not specifiy it was work related, THey will be hearing form me monday morning. I type 40 hrs per week for years in the govt, but they did not specify on my drs note. URRR! Laurie In WACarpal TUnnel, Behcets, hypothyroid, back pain, sleep apnea, adhd, depression, anxiety.r we having fun yet? <><

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That's never a good thing.

OH I'm a new member btw

>

> oh DEAR, Laurie!! I am so sorry that you now have to go at it all

again!! WHY don't the docs check their essential info first!!?? I

know they are overwhelmed too, but they should know this routine by

heart by now!!

>

> Power to you in your appeal et al !!

> Jean

>

> denied

>

>

> My applying to OWCP Dept of Labor for Carpal Tunnel SUrgery is

denied,

> because my drs explanation did not specifiy it was work related,

THey

> will be hearing form me monday morning. I type 40 hrs per week

for

> years in the govt, but they did not specify on my drs note. URRR!

> Laurie In WA

> Carpal TUnnel, Behcets, hypothyroid, back pain, sleep apnea,

adhd,

> depression, anxiety.

> r we having fun yet? <><

>

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I;M sorry;; This isnt right or fair;; but then ,when is the Government fair to us peons;; Dont give up Hugs DortLaurie H <Mana_olana@...> wrote: My applying to OWCP Dept of Labor for Carpal Tunnel SUrgery is denied, because my drs explanation did not specifiy it was work related, THey will be hearing form me monday morning. I type 40 hrs per week for years in the govt, but they did not specify on my drs note. URRR! Laurie In WACarpal TUnnel, Behcets, hypothyroid, back pain, sleep apnea,

adhd, depression, anxiety.r we having fun yet? <><

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>

> My applying to OWCP Dept of Labor for Carpal Tunnel SUrgery is

denied,

> because my drs explanation did not specifiy it was work related,

THey

> will be hearing form me monday morning. I type 40 hrs per week for

> years in the govt, but they did not specify on my drs note. URRR!

> Laurie In WA

> Carpal TUnnel, Behcets, hypothyroid, back pain, sleep apnea, adhd,

> depression, anxiety.

> r we having fun yet? <><

>

My first request for Project Mobility was denied....just because I

wasn't completely disabled and didn't use a walker.

But it is still hard for me to handle cold weather or extremely warm

temperatures. I had both my rheumatologist and my sister (who is a

nurse) to write letters....and I got approved....but ONLY on a

conditional basis....

And no....we ain't having fun yet. lol

Candy

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  • 1 year later...

Medicaid/Wyoming EqualityCare denied my request for cochlear implant coverage.

Rocky Mountain Cochlear Implant Center is going to work with OMS Insurance

Support on appealing the denial, and I've also contacted Advanced Bionic's

insurance support as well. I am aware of the Let Them Hear Foundation, but

according to their website they are not accepting any appeal requests right now,

so hopefully RMCIC, OMS and AB will be able to work their magic somehow.

Meghan

http://cdm85.blogspot.com

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Sorry to hear this Meghan! How disappointing. I hope that the appeal will

yield a more positive result.

Would Obama's propose healthcare overhaul in your country change any of this

lack of eligibility on your part?

>

> Medicaid/Wyoming EqualityCare denied my request for cochlear implant coverage.

Rocky Mountain Cochlear Implant Center is going to work with OMS Insurance

Support on appealing the denial, and I've also contacted Advanced Bionic's

insurance support as well. I am aware of the Let Them Hear Foundation, but

according to their website they are not accepting any appeal requests right now,

so hopefully RMCIC, OMS and AB will be able to work their magic somehow.

>

>

> Meghan

> http://cdm85.blogspot.com

>

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