Guest guest Posted April 19, 1999 Report Share Posted April 19, 1999 What ins. did you have? Pat > Re: (no subject) > > > > > Dr. Rutledge, > > By the way, I had gastric bypass 2 years ago. It was a written exclusion > from > my HMO's policy. I obtained letters from all of my Docs and wrote one > myself. > I hand delivered them straight to the medical director himself. They paid > for > every penny!! This particular HMO has since, approved many more > although it > is still a written exclusion from their policy. > Thank you in advance for your time! > > in Atlanta > > > > ------------------------------------------------------------------------ > Come check out our brand new web site! > http://www.onelist.com > Onelist: Making the Internet intimate > ------------------------------------------------------------------------ > This message is from the Mini-Gastric Bypass List at Onelist.com > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 1999 Report Share Posted April 19, 1999 What ins. did you have? Pat > Re: (no subject) > > > > > Dr. Rutledge, > > By the way, I had gastric bypass 2 years ago. It was a written exclusion > from > my HMO's policy. I obtained letters from all of my Docs and wrote one > myself. > I hand delivered them straight to the medical director himself. They paid > for > every penny!! This particular HMO has since, approved many more > although it > is still a written exclusion from their policy. > Thank you in advance for your time! > > in Atlanta > > > > ------------------------------------------------------------------------ > Come check out our brand new web site! > http://www.onelist.com > Onelist: Making the Internet intimate > ------------------------------------------------------------------------ > This message is from the Mini-Gastric Bypass List at Onelist.com > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 19, 1999 Report Share Posted April 19, 1999 What ins. did you have? Pat > Re: (no subject) > > > > > Dr. Rutledge, > > By the way, I had gastric bypass 2 years ago. It was a written exclusion > from > my HMO's policy. I obtained letters from all of my Docs and wrote one > myself. > I hand delivered them straight to the medical director himself. They paid > for > every penny!! This particular HMO has since, approved many more > although it > is still a written exclusion from their policy. > Thank you in advance for your time! > > in Atlanta > > > > ------------------------------------------------------------------------ > Come check out our brand new web site! > http://www.onelist.com > Onelist: Making the Internet intimate > ------------------------------------------------------------------------ > This message is from the Mini-Gastric Bypass List at Onelist.com > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 1999 Report Share Posted April 20, 1999 - Yes the psychiatrist does need to write a letter. I think he wrote it to Dr. Rutledge. Yes, all my doctors wrote their letters to Dr Rutledge. Basically, he just certifies that he thinks you understand what you are about to undertake, that there are no serious psychological problems that might complicate the surgery, and it's also so that you have a relationship started with a doc if you should experience symptoms of depressions post-op. Some folks do, and it's easier to get you to treatment if you already know someone that you feel comfortable with. Think of it as a positive experience. It really is. Katy 3/15/99--344 4/19/99--307 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 1999 Report Share Posted April 20, 1999 Katy, no it wasn't Daphne.. we had a normal recovery:) the pt that had wls before us had a hard time:( but is doing ok now:) she had a " leak " had to go back in. but we did fine:) (no subject) >From: KMusolino@... > >Daphne-- > >You had surgery the day after I did. Harper was there, too. Did we >meet in the hospital. I remember stopping by somebody's room but I was still >a little foggy and don't remember the name. Was it you? > >Katy Musolino > >------------------------------------------------------------------------ >Start a new hobby. Meet a new friend. >http://www.ONElist.com >ONElist: The leading provider of free e-mail list services! >------------------------------------------------------------------------ >This message is from the Mini-Gastric Bypass List at Onelist.com > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 1999 Report Share Posted April 20, 1999 Katy, no it wasn't Daphne.. we had a normal recovery:) the pt that had wls before us had a hard time:( but is doing ok now:) she had a " leak " had to go back in. but we did fine:) (no subject) >From: KMusolino@... > >Daphne-- > >You had surgery the day after I did. Harper was there, too. Did we >meet in the hospital. I remember stopping by somebody's room but I was still >a little foggy and don't remember the name. Was it you? > >Katy Musolino > >------------------------------------------------------------------------ >Start a new hobby. Meet a new friend. >http://www.ONElist.com >ONElist: The leading provider of free e-mail list services! >------------------------------------------------------------------------ >This message is from the Mini-Gastric Bypass List at Onelist.com > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 1999 Report Share Posted April 21, 1999 Also I strongly encourage you to contact the billing department for your insurance asking them for a copy of all costs for your medical care both within the facility or outside, be it lab studies, pharmacy or radiology. When you tell them that it has cost them over $x amount to care for you with minimal secondary problems due to obesity, what will it cost them when you have severe secondary complications. Right now, Kaiser is having a rough time financially and this is what did it for me. I told them they stress " preventative medicine " and how can they refuse this procedure if it can " prevent " my current status from getting worse? I approached my second appeal with health reasons and cost factors. I was very honest with my feelings in telling them how it felt to be morbidly obese and my fears of dying from obesity due to secondary complications. Good luck in your appeals... Also, just want to make sure you know that when your insurance company agrees to allow you a second level appeal, you have a right to sit down before the committee and plead your case in person. I strongly urge you to do this. So many times, as a health care professional myself, you wonder just how much does a person want something, or how bad do they feel. It is better to see a patient face to face and hear what they have to say. If I can be of any other assistance, please let me know. Thanks, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 22, 1999 Report Share Posted April 22, 1999 Kathy, Focus strictly on the health and the costs of having the surgery Vs the costs of keeping you up when you are decrepit from disease. Also, FYI, find out where this guy is and send him a letter asking for his help: Dr. Ernie Bodai Chief of Surgery Kaiser Advocate of Women's Health Issues. Worth a try. Probably has office at Kaiser's home facility. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 1999 Report Share Posted April 23, 1999 Kathy, I wanted to let you know I sent Joy and the others on my appeal committee an email today with a progress update. They do not know we talk on line but I wonder if they realize what an impact having the procedure has done for me , could it help others seeking approval? Let me know how things are going please. Take care, karen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 1999 Report Share Posted April 23, 1999 Kathy, I wanted to let you know I sent Joy and the others on my appeal committee an email today with a progress update. They do not know we talk on line but I wonder if they realize what an impact having the procedure has done for me , could it help others seeking approval? Let me know how things are going please. Take care, karen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 1999 Report Share Posted April 23, 1999 Kathy, I wanted to let you know I sent Joy and the others on my appeal committee an email today with a progress update. They do not know we talk on line but I wonder if they realize what an impact having the procedure has done for me , could it help others seeking approval? Let me know how things are going please. Take care, karen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 1999 Report Share Posted April 23, 1999 Kathy, as you know, you should have all the materials you want the second level to review to Joy in advance. When I sat down with the group, I talked from the heart... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 1999 Report Share Posted April 23, 1999 Thanks so much for your thoughts. I am glad that you are posting more often. I am in the beginning stages of my second appeal. Should I put together a formal presentation or should I just talk from the heart?? What about visual aids, handouts, videos, overheads, etc. Am I going overboard on this??? How long after the hearing did you find out their decision?? I filed a second complaint with the insurance commisioner today. My insurance EOC states that I have the right to be present at the first appeal hearing. When I had ask Joy if I could be there for the first appeals, she told me no. She said that I could only go to the second level appeal. I hate harrassing everyone, but I don't know what else to do. I keep thinking that this will be another summer that my kids won't have a mother....... Kathy Kaiser Permanente appealing again Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 1999 Report Share Posted April 23, 1999 Thanks so much for your thoughts. I am glad that you are posting more often. I am in the beginning stages of my second appeal. Should I put together a formal presentation or should I just talk from the heart?? What about visual aids, handouts, videos, overheads, etc. Am I going overboard on this??? How long after the hearing did you find out their decision?? I filed a second complaint with the insurance commisioner today. My insurance EOC states that I have the right to be present at the first appeal hearing. When I had ask Joy if I could be there for the first appeals, she told me no. She said that I could only go to the second level appeal. I hate harrassing everyone, but I don't know what else to do. I keep thinking that this will be another summer that my kids won't have a mother....... Kathy Kaiser Permanente appealing again Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 1999 Report Share Posted April 23, 1999 Thanks so much for your thoughts. I am glad that you are posting more often. I am in the beginning stages of my second appeal. Should I put together a formal presentation or should I just talk from the heart?? What about visual aids, handouts, videos, overheads, etc. Am I going overboard on this??? How long after the hearing did you find out their decision?? I filed a second complaint with the insurance commisioner today. My insurance EOC states that I have the right to be present at the first appeal hearing. When I had ask Joy if I could be there for the first appeals, she told me no. She said that I could only go to the second level appeal. I hate harrassing everyone, but I don't know what else to do. I keep thinking that this will be another summer that my kids won't have a mother....... Kathy Kaiser Permanente appealing again Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 23, 1999 Report Share Posted April 23, 1999 Fw: (no subject) > >> I don't usually pass on news like this. I know you are busy; but >sometimes >> we have to pause and truly remember what life is about . . . >> so I pass on this sad, sad news . . . >> >> There was a great loss today in the entertainment world. The man who >wrote >> the song " Hokey Pokey " died. What was really horrible is that they had >> trouble keeping the body in the casket. They'd put his left leg in, they >> took the left leg out, they put the left leg in and......... well, you >know >> the rest. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 1999 Report Share Posted April 24, 1999 , I am having no luck in locating Dr. Bodai. Can you send more information about him....what office?? what state?? is he an internist or what?? HELP!!!!! Thanks for all your support and help - you are the greatest!!!!!!!! Kathy Kaiser Permanente appealing again Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 1999 Report Share Posted April 24, 1999 , I am having no luck in locating Dr. Bodai. Can you send more information about him....what office?? what state?? is he an internist or what?? HELP!!!!! Thanks for all your support and help - you are the greatest!!!!!!!! Kathy Kaiser Permanente appealing again Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 1999 Report Share Posted April 24, 1999 Kathy, All I know is that he is the chief of surgery for Kaiser. And he is supposed to be an advocate for women's health issues. Guess where I found his name? At the post office, on a card, with information about breast cancer awareness. Do you have anything with Kaiser's corp. address, home office, etc.? I would try to reach him there. Sorry I can't give you any more info. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 1999 Report Share Posted April 24, 1999 Kathy, All I know is that he is the chief of surgery for Kaiser. And he is supposed to be an advocate for women's health issues. Guess where I found his name? At the post office, on a card, with information about breast cancer awareness. Do you have anything with Kaiser's corp. address, home office, etc.? I would try to reach him there. Sorry I can't give you any more info. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 1999 Report Share Posted April 24, 1999 I talked to a friend on disability because of depression due to obesity about helping me fill out papers I thought that if I could get on disability for obesity that my ins. would have to approve or isist that I have the surgery. My friend also go medi-cal and I think that may cover it but it might be medicaid or medicare. I want her to think abou the surgery she is huge and has many medical problems. but she is totally against it,her mom had it and worked years ago. Kathy wrote: > From: thestewarts@... (Kathy ) > > Group and especially kathy in Statesville > > Could some of you tell me more about the Social securities requirements > for disability. I have seen someone post that a BMI of 51 or over > qualifies you for complete disability. Could you tell me more and were > I can find the supporting documents or standards on the > internet????Thanks for the time > Kathy > Kasier Permanente appealing again > > ------------------------------------------------------------------------ > Start a new hobby. Meet a new friend. > http://www.ONElist.com > ONElist: The leading provider of free e-mail list services! > ------------------------------------------------------------------------ > This message is from the Mini-Gastric Bypass List at Onelist.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 1999 Report Share Posted April 24, 1999 I talked to a friend on disability because of depression due to obesity about helping me fill out papers I thought that if I could get on disability for obesity that my ins. would have to approve or isist that I have the surgery. My friend also go medi-cal and I think that may cover it but it might be medicaid or medicare. I want her to think abou the surgery she is huge and has many medical problems. but she is totally against it,her mom had it and worked years ago. Kathy wrote: > From: thestewarts@... (Kathy ) > > Group and especially kathy in Statesville > > Could some of you tell me more about the Social securities requirements > for disability. I have seen someone post that a BMI of 51 or over > qualifies you for complete disability. Could you tell me more and were > I can find the supporting documents or standards on the > internet????Thanks for the time > Kathy > Kasier Permanente appealing again > > ------------------------------------------------------------------------ > Start a new hobby. Meet a new friend. > http://www.ONElist.com > ONElist: The leading provider of free e-mail list services! > ------------------------------------------------------------------------ > This message is from the Mini-Gastric Bypass List at Onelist.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 1999 Report Share Posted April 24, 1999 kathy i get disabilty thru the goverment..the main disabilty was my weight the next one was the weaking of my bones they turned me down the first time then i went in front of a judge ..and talked to him ...I had no lawyer..i won had it within the next month....jackie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 1999 Report Share Posted April 24, 1999 kathy i get disabilty thru the goverment..the main disabilty was my weight the next one was the weaking of my bones they turned me down the first time then i went in front of a judge ..and talked to him ...I had no lawyer..i won had it within the next month....jackie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 1999 Report Share Posted April 24, 1999 Jackie What are their weight requirements for disability due to obesity??? Thanks Kathy Kasier Permanente appealing again Quote Link to comment Share on other sites More sharing options...
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