Frustration again

[Guest guest]

Hi Kay:

This is from my post 14757 from March this year. You can see the

rest of it by typing the number in search messages.

The medical facilities and physicians are not equipped to conduct an

appeal except on a very basic level. It is not their mission or

responsibility. The problem is related to the contract that each

person has with their insurance company. Some resurfacing

surgeons/offices had early success with Level I appeals. Now, the

insurance companies are more resistant and the appeal process is to

complicated for them.

I suggest that surface hippys in the US try to assist each other.

Right now, those who have had successful appeals should indicate

their willingness to supply copies of their appeal letters, and

other documents which would be helpful to others. THIS HAS ALREADY

BEEN DONE BY SEVERAL PEOPLE. I suggest that those in need contact

those people off-line so that we don't openly post this information

just yet. Perhaps later we can put together a package of documents

which can be emailed to new members. I am already working on this.

PERSONAL INFORMATION SUCH AS SOCIAL SECURITY NUMBERS, MEDICAL RECORD

INFORMATION AND ANYTHING ELSE YOU DO NOT WANT POSTED ON THE INTERNET

SHOULD BE DELETED FROM THE DOCUMENTS.

I have 2 word files containing some pretty good appeal documents if

you are interested. Chuck will send you some useful documents

and an unpublished paper if you call or email him.

in NC

> > kay, i had a great conversation with chuck adams at jri. he

said

> that dr.

> > amstutz has a 98% rule and that means that 98% of chd patients

can

> have

> > resurfacing. he uses the conserve plus prosthesis. it would

> depend on the

> > severity of your chd. there are two other docs there

> resurfacing. eileen

> >

> >

> >