Re: Insurance Appeal letter

[Guest guest]

Hi Debbie--I " m demyelinated too..... & can't think worth a SQUAT! Where is

your level of demyelination?

take care,

[] Insurance Appeal letter

> Hello, I am currently being treated by Dr. due to toxic mold.

> My antibodies are abnormally high from 17 different kinds of molds and

> toxins. I have demylanization and suppressed immune system.

> Here is my problem. My Insurance denied my claim based on medical

> tests don't match diagnosis, prices charged are 3 to 4 times what they

> should be and not a medical necessity. A board of " Medical doctors "

> made the decision. Dr. 's office is appealing on my behalf and

> his clinic has asked me to write an appeal letter also. Has anyone

> here had to do this and if so been successful in overturning the appeal?

>

> My brain doesn't operate very well on putting things together and I

> don't want to mess this up.

> I have nothing without insurance.

>

> thanks so much for any help.

> Debbie

>

>

>

>

>

>

>

>

>

>

>

> FAIR USE NOTICE:

>

>

>

[Guest guest]

We've been with Dr. & have had past ins problems - his office

is great on working with you & the ins co. I wrote the ins company &

finally the final review board agreed that we really did need

everything has prescribed. This has happened 2 different

times. These review medical boards are rarely specialists in the field

they're reviewing. It was an orth surgeon that was reviewing our

neurological records for the ins co. Go figure.... Anything that is

expensive is going to be reviewed - bottom line is that ins co's don't

want to pay - whether it's home ins, car ins or health ins. That takes

away from their bottom line.

By state law in our state, IL, the patient has to ask for the appeal -

that's probably why his office has asked you to write the letter.

Basically, you're stating how sick you are, your symptoms and how

desperatley you need medical help and you'd like them to take another

look. The post that suggested getting an attorney might be a good idea

if you can afford it. It might not cost too much to get him to do a

letter. Check your policy for the guidelines of an appeal.

Good luck,

SW

In , " panhandlepeddlers " <djdeen@...> wrote:

>

> Hello, I am currently being treated by Dr. due to toxic mold.

> My antibodies are abnormally high from 17 different kinds of molds and

> toxins. I have demylanization and suppressed immune system.

> Here is my problem. My Insurance denied my claim based on medical

> tests don't match diagnosis, prices charged are 3 to 4 times what they

> should be and not a medical necessity. A board of " Medical doctors "

> made the decision. Dr. 's office is appealing on my behalf and

> his clinic has asked me to write an appeal letter also. Has anyone

> here had to do this and if so been successful in overturning the appeal?

>

> My brain doesn't operate very well on putting things together and I

> don't want to mess this up.

> I have nothing without insurance.

>

> thanks so much for any help.

> Debbie

>

[Guest guest]

Where is

> your level of demyelination?

>

I guess I don't know where my level is. I have good days and other days

I can't think, spell, write or talk. I have some nerve problems along

my right side and I try and deal with the pain. My MRI's show white

matter on the brain. I am doing much better since getting away from the

mold source.

2 of my past doctors thought I was in the beginings of MS. Dr.

explained that my symptoms only mimic MS. I am supposed to

start IVIG treatments for it.

How about you?

Debbie

[Guest guest]

-Thank you so much.

This has helped me a lot. I am trying not to stress about

being denied and Dr. 's office has been very great.

Suck's to know that an insurance company will pay countless

claims as long as the doctor is in network, who cares if you

get better..............I am hoping that will work to my

benefit.

Debbie

-- In , " wiedb " <wiedb@...> wrote:

>

> We've been with Dr. & have had past ins problems - his

office

> is great on working with you & the ins co. I wrote the ins company &

> finally the final review board agreed that we really did need

> everything has prescribed. This has happened 2 different

> times. These review medical boards are rarely specialists in the

field

> they're reviewing. It was an orth surgeon that was reviewing our

> neurological records for the ins co. Go figure.... Anything that is

> expensive is going to be reviewed - bottom line is that ins co's

don't

> want to pay - whether it's home ins, car ins or health ins. That

takes

> away from their bottom line.

>

> By state law in our state, IL, the patient has to ask for the

appeal -

> that's probably why his office has asked you to write the letter.

> Basically, you're stating how sick you are, your symptoms and how

> desperatley you need medical help and you'd like them to take

another

> look. The post that suggested getting an attorney might be a good

idea

> if you can afford it. It might not cost too much to get him to do a

> letter. Check your policy for the guidelines of an appeal.

> Good luck,

> SW

>

> In , " panhandlepeddlers " <djdeen@>

wrote:

> >

> > Hello, I am currently being treated by Dr. due to toxic

mold.

> > My antibodies are abnormally high from 17 different kinds of

molds and

> > toxins. I have demylanization and suppressed immune system.

> > Here is my problem. My Insurance denied my claim based on

medical

> > tests don't match diagnosis, prices charged are 3 to 4 times what

they

> > should be and not a medical necessity. A board of " Medical

doctors "

> > made the decision. Dr. 's office is appealing on my

behalf and

> > his clinic has asked me to write an appeal letter also. Has

anyone

> > here had to do this and if so been successful in overturning the

appeal?

> >

> > My brain doesn't operate very well on putting things together and

I

> > don't want to mess this up.

> > I have nothing without insurance.

> >

> > thanks so much for any help.

> > Debbie

> >

>

[Guest guest]

--- Hi Debbie, sounds like you have MCS (multiple chemical

sensativity), have you been dignosed with it? In

, " panhandlepeddlers " <djdeen@...> wrote:

>

> Where is

> > your level of demyelination?

> >

> I guess I don't know where my level is. I have good days and other

days

> I can't think, spell, write or talk. I have some nerve problems

along

> my right side and I try and deal with the pain. My MRI's show

white

> matter on the brain. I am doing much better since getting away from

the

> mold source.

> 2 of my past doctors thought I was in the beginings of MS. Dr.

> explained that my symptoms only mimic MS. I am supposed

to

> start IVIG treatments for it.

>

> How about you?

>

> Debbie

>

[Guest guest]

I have not been dignosed with it. I don't know a whole lot about MCS.

The biggest problem for me at this moment is food. Any food that I

put into my body I have some reaction to. Nausea, bloating, almost

immediate vison disturbance, runny right side of nose,fatige and just

overall bad feeling. I drink a protien supplement for breakfast and

lunch and then I don't have to deal with most of those problems.

Actually I feel pretty good as long as I don't eat solid food.

Sometimes my fatigue is a drug like induced state.

I consume about 1000 calories a day (for months) and can't lose a

pound. I have been dignosed with Hasimoto's thyrodidus and just

started thyroid meds, but can't tell that is helping so far.

> >

> > Where is

> > > your level of demyelination?

> > >

> > I guess I don't know where my level is. I have good days and

other

> days

> > I can't think, spell, write or talk. I have some nerve problems

> along

> > my right side and I try and deal with the pain. My MRI's show

> white

> > matter on the brain. I am doing much better since getting away

from

> the

> > mold source.

> > 2 of my past doctors thought I was in the beginings of MS. Dr.

> > explained that my symptoms only mimic MS. I am supposed

> to

> > start IVIG treatments for it.

> >

> > How about you?

> >

> > Debbie

> >

>

[Guest guest]

From: panhandlepeddlers

Sent: Thursday, 2006.4.27 7:12 PM

Subject: [] Re: Insurance Appeal letter

The biggest problem for me at this moment is food. Any food that I

put into my body I have some reaction to. Nausea, bloating, almost

immediate vison disturbance, runny right side of nose,fatige and just

overall bad feeling. I drink a protien supplement for breakfast and

lunch and then I don't have to deal with most of those problems.

Actually I feel pretty good as long as I don't eat solid food.

* That's interesting. What protein supplement do you use? Generally, it's

the proteins in food that we react to. Presumably you're using a supplement

with predigested (ie hydrolyzed) protein. Thanks.

[Guest guest]

---my stomach is in bad shape to, I used to have dierrhia many times

a day, often with blood. I had dierrhia from the start of my exposure

that got continually worse. I'd have dierrhia within 5 to 10 minutes

after I ate. the pain was bad, rolling,bloating, growling(people

could hear it ) gassy. I finally was dignosed with food allergies to

corn and yeast by the same doctor that dignosed my MCS. omitting all

corn products and yeast products helped my stomach a lot. I to

hardly eat much but cant lose wieght. I think a lot of us here have

stomach

problems.

In

, " panhandlepeddlers " <djdeen@...> wrote:

>

> I have not been dignosed with it. I don't know a whole lot about

MCS.

>

> The biggest problem for me at this moment is food. Any food that I

> put into my body I have some reaction to. Nausea, bloating, almost

> immediate vison disturbance, runny right side of nose,fatige and

just

> overall bad feeling. I drink a protien supplement for breakfast

and

> lunch and then I don't have to deal with most of those problems.

> Actually I feel pretty good as long as I don't eat solid food.

> Sometimes my fatigue is a drug like induced state.

> I consume about 1000 calories a day (for months) and can't lose a

> pound. I have been dignosed with Hasimoto's thyrodidus and just

> started thyroid meds, but can't tell that is helping so far.

>

>

>

>

> >

> > --- Hi Debbie, sounds like you have MCS (multiple chemical

> > sensativity), have you been dignosed with it? In

> > , " panhandlepeddlers " <djdeen@>

wrote:

> > >

> > > Where is

> > > > your level of demyelination?

> > > >

> > > I guess I don't know where my level is. I have good days and

> other

> > days

> > > I can't think, spell, write or talk. I have some nerve problems

> > along

> > > my right side and I try and deal with the pain. My MRI's show

> > white

> > > matter on the brain. I am doing much better since getting away

> from

> > the

> > > mold source.

> > > 2 of my past doctors thought I was in the beginings of MS. Dr.

> > > explained that my symptoms only mimic MS. I am

supposed

> > to

> > > start IVIG treatments for it.

> > >

> > > How about you?

> > >

> > > Debbie

> > >

> >

>

[Guest guest]

I was IgG tested and stayed on a diet relative to

these foods avoiding those I was intolerant. I was

finally able to stop my diarrhea after 10 years of

being plagued with this problem.

_____

From:

[mailto: ] On Behalf

Of who

Sent: Friday, April 28, 2006 12:54 AM

Subject: [] Re: Insurance Appeal

letter

* ---my stomach is in bad shape to, I used

to have dierrhia many times

a day, often with blood. I had dierrhia from the

start of my exposure

that got continually worse. I'd have dierrhia

within 5 to 10 minutes

after I ate. the pain was bad, rolling,bloating,

growling(people

could hear it ) gassy. I finally was dignosed with

food allergies to

corn and yeast by the same doctor that dignosed my

MCS. omitting all

corn products and yeast products helped my stomach

a lot. I to

hardly eat much but cant lose wieght. I think a

lot of us here have

stomach

problems.

........rest snipped

_____

[Guest guest]

I s]aw your words re demylination. Initially I was

diagnose some years ago with demylination based on

MRI . Over a few years ,this diagnosis was changed

to multiple sclerosis and now a chronic relapsing

form of multiple sclerosis. Personally I was put

on IVIG treatments for a period of time during

hospitalization, received early relief but quick

relapses so after about 5 months ,it was

discontinued from my treatment protocol. It is

expensive and many insurance companies are denying

claims or being very careful to continue the

protocol/.

_____

From:

[mailto: ] On Behalf

Of who

Sent: Thursday, April 27, 2006 8:57 PM

Subject: [] Re: Insurance Appeal

letter

--- Hi Debbie, sounds like you have MCS (multiple

chemical

sensativity), have you been dignosed with it? In

, " panhandlepeddlers "

<djdeen@...> wrote:

>

> Where is

> > your level of demyelination?

> >

> I guess I don't know where my level is. I have

good days and other

days

> I can't think, spell, write or talk. I have some

nerve problems

along

> my right side and I try and deal with the pain.

My MRI's show

white

> matter on the brain. I am doing much better

since getting away from

the

> mold source.

> 2 of my past doctors thought I was in the

beginings of MS. Dr.

> explained that my symptoms only mimic

MS. I am supposed

to

> start IVIG treatments for it.

>

> How about you?

>

> Debbie

>

FAIR USE NOTICE:

[Guest guest]

Hi debbie--my level is at L 1-2. i'm completely demyelinated, very nearly

NEVER walked again. i have many symptoms, debbie-- & it all STINKS. nothing

below my waist works, except my legs.....after MONTHS of physical therapy.

and even now there are numerous parts of me that are still paralyzed. :>(

take care,

victoria

[] Re: Insurance Appeal letter

> Where is

>> your level of demyelination?

>>

> I guess I don't know where my level is. I have good days and other days

> I can't think, spell, write or talk. I have some nerve problems along

> my right side and I try and deal with the pain. My MRI's show white

> matter on the brain. I am doing much better since getting away from the

> mold source.

> 2 of my past doctors thought I was in the beginings of MS. Dr.

> explained that my symptoms only mimic MS. I am supposed to

> start IVIG treatments for it.

>

> How about you?

>

> Debbie

>

>

>

>

>

>

>

>

> FAIR USE NOTICE:

>

>

>

[Guest guest]

I use a Weight loss drink mix called Slimstyles. It is a Whey

protien supplement with something called PGX.

I still have some bloating after ingesting this product, but it is by

far the best thing my body will tolerate and not cause me severe

fatigue and I will stay full for about 4 hours.

I have tried food eliminations for a couple of years and no matter

what solid foods I eat I have reactions to. I believe my worst

reactions comes from my body actually having to digest food. I take

digestive enzymes to help me some. During digestion my gut is very

loud with grinding and churning.

That is interesting about the protien.

Debbie

--- In , " Bjerring " <jamesbj@...>

wrote:

>

> From: panhandlepeddlers

>

> Sent: Thursday, 2006.4.27 7:12 PM

> Subject: [] Re: Insurance Appeal letter

>

>

> The biggest problem for me at this moment is food. Any food that

I

> put into my body I have some reaction to. Nausea, bloating,

almost

> immediate vison disturbance, runny right side of nose,fatige and

just

> overall bad feeling. I drink a protien supplement for breakfast

and

> lunch and then I don't have to deal with most of those problems.

> Actually I feel pretty good as long as I don't eat solid food.

>

> * That's interesting. What protein supplement do you use?

Generally, it's the proteins in food that we react to. Presumably

you're using a supplement with predigested (ie hydrolyzed) protein.

Thanks.

>

>

>

>

[Guest guest]

I know all of those symptoms you suffer from. I will alternate

between dierriha and constipation. I have done food eliminations and

nothing seems to make it any better. my fatigue seems to be worst

with anything that might be starchy. i try to stay away from those

type foods.

It is so hard sometimes.

I fly to Houston to see my doctor and I hardly eat because I am

afraid of a fatige onset so I wait until I can get to my room before

I eat. It makes for a very long and stressful trip.

> > > >

> > > > Where is

> > > > > your level of demyelination?

> > > > >

> > > > I guess I don't know where my level is. I have good days and

> > other

> > > days

> > > > I can't think, spell, write or talk. I have some nerve

problems

> > > along

> > > > my right side and I try and deal with the pain. My MRI's

show

> > > white

> > > > matter on the brain. I am doing much better since getting

away

> > from

> > > the

> > > > mold source.

> > > > 2 of my past doctors thought I was in the beginings of MS.

Dr.

> > > > explained that my symptoms only mimic MS. I am

> supposed

> > > to

> > > > start IVIG treatments for it.

> > > >

> > > > How about you?

> > > >

> > > > Debbie

> > > >

> > >

> >

>