Guest guest Posted May 3, 2003 Report Share Posted May 3, 2003 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! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 3, 2003 Report Share Posted May 3, 2003 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) > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 5, 2003 Report Share Posted May 5, 2003 > 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2004 Report Share Posted March 12, 2004 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, > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2004 Report Share Posted March 12, 2004 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, > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2004 Report Share Posted March 12, 2004 > 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2004 Report Share Posted March 12, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2004 Report Share Posted March 12, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2004 Report Share Posted March 12, 2004 > 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! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2004 Report Share Posted March 12, 2004 > 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! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2004 Report Share Posted March 12, 2004 > 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2004 Report Share Posted March 12, 2004 > 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2004 Report Share Posted March 12, 2004 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 > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2004 Report Share Posted March 12, 2004 In a message dated 3/13/2004 12:36:19 AM Central Standard Time, moobabies@... writes: lol...that is like the best dumb-A$$ excuse to deny surgery I've seen so far. Jo ____________________________________ I SECOND THAT!! in Bama VBG 1982 (lost from 433lbs to 270's) VBG -RNY1996 revision(Lost from 343 to 299) RNY-DS revision Dec 2002 -down 130 lbs (377.7 to 247.2 and still going) BMI 39.4...No longer Morbidly obese! Homepage address- http://hometown.aol.com/mdl1031/myhomepage/profile.html Many thanks to Dr. K willing to take on a 3rd timer....LOL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 12, 2004 Report Share Posted March 12, 2004 > > > I looked it up online. The definition said something about > > obesity related to consuming more calories than are expended > > in normal activity. i.e. > > You're overweight because you overeat. Typical uninformed > > insurance position. Darn if that doesn't sound like a great reason to have a surgery that decreases your stomach size and with malabsorption. lol...that is like the best dumb-A$$ excuse to deny surgery I've seen so far. Jo Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 13, 2004 Report Share Posted March 13, 2004 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 19, 2007 Report Share Posted November 19, 2007 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? <>< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 19, 2007 Report Share Posted November 19, 2007 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? <>< > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 19, 2007 Report Share Posted November 19, 2007 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? <>< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 20, 2007 Report Share Posted November 20, 2007 > > 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2009 Report Share Posted November 10, 2009 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2009 Report Share Posted November 10, 2009 I have no idea, it was Rocky Mountain Ear Center that got the letter, not I. > > Rocky Mt. Cochlear Implant Center is the best!! > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2009 Report Share Posted November 11, 2009 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 > Quote Link to comment Share on other sites More sharing options...
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