Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 Lyssa, My ins. is London Health/Health care value management. told me to write a very strong letter to the Ins. people. Also that Dr. Thayer will also write a letter on my behalf. I have already called my regualr Dr. who refered me to Dr.Thayer to write me a letter stating why I need this surgery. When I talked to and then my Ins. I felt as if my heart had been ripped out...I cryied like hell and couldn't breathe. All I want is my life back...ya know? Thank You so much for your help and I will talk to this lawyer... Thanks again... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 Joni, Thank you so much... I'll do anything that will prove that being 137lbs over weight and having a bmi of 42 is not healthy and asking for a surgery to help me is not " cosmentic " . Thanks again.. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 Lyssa, Kshort isn't not a member of aol...Does she still write in the group? ps. thank you for all the information... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 , I am so sorry to hear about your insurance. Does you insurer have a review board. I would call them and tell them that their decision is unacceptable and that you want it to go before a board. Ask them what type of documentation they need from you. I did not have to do this, but I'm sure their are others on-line who had similar experiences. Hugs, Joni - Dr. Thayer 11/27/00 -----Original Message-----From: nnasheart@... Sent: Friday, February 16, 2001 3:41 PMTo: OSSG-NewEngland Subject: HELPHELP!!! I have received a call from at Dr. Thayers office today. It seems my insurance has denied my surgery! She is trying to help me make them change their minds about it, but I honestly have no hope any more of having this surgery. My ins. has said that this surgery is "cosmetic" and not necessary...which I find to be nothing but a pile of dog shit. Like I just suddenly chose to have major surgery so I could be skinny...What a joke! If anyone out there has any ideas that might help me.. I would greatly appreciate any and all ideas.Thank you all in advance.... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 Ask them to put the denial in writing to you & the reasons for it. Also get a copy of your benefits health plan book to see what is says for coverage on wls. Who is your insurer? Once you have that info I'd get Dr. T to write a letter explaining why its not cosmetic and how it is life saving. APPEAL they count on you not appealing and most peope win on appeal. You could also talk to an obesity lawyer named Walter Lindstrom http://www.obesitylaw.com/ HELP HELP!!! I have received a call from at Dr. Thayers office today. It seems my insurance has denied my surgery! She is trying to help me make them change their minds about it, but I honestly have no hope any more of having this surgery. My ins. has said that this surgery is " cosmetic " and not necessary...which I find to be nothing but a pile of dog shit. Like I just suddenly chose to have major surgery so I could be skinny...What a joke! If anyone out there has any ideas that might help me.. I would greatly appreciate any and all ideas. Thank you all in advance.... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 Sorry to hear about that. Who's your insurance company? Perhaps someone else who has been denied and appealed and won can give you some advice. I'm still waiting for approval myself... -- S. HELP HELP!!! I have received a call from at Dr. Thayers office today. It seems my insurance has denied my surgery! She is trying to help me make them change their minds about it, but I honestly have no hope any more of having this surgery. My ins. has said that this surgery is " cosmetic " and not necessary...which I find to be nothing but a pile of dog shit. Like I just suddenly chose to have major surgery so I could be skinny...What a joke! If anyone out there has any ideas that might help me.. I would greatly appreciate any and all ideas. Thank you all in advance.... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 I don't know if London Health/Health care value management is different than just Health Care Value Management but I found this at the www.obesityhelp.com If Im not mistaken Kshort is on our list so perhaps she can help out further Lyssa Health Care Value Management Approved after appeal letter (09/29/00) Open RNY Weeks to approval : 3+ Pre-Op BMI : 45.8 Comorbidities : GERD, arthritis, joint pain, depression Policy : Must be medically necessary Comments : All dealings were professional. I think it payed off to be persistent. It may be that they always wait for an appeal to approve this type of surgery. I recommend that if you have this insurance that you gather all your information on your weight struggle and past attempts to lose weight. Have as much documentation as possible and be prepared to use it if necessary. Source: kshort1100@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 , Might i ask what your current stats are? I am thinking about the surgery and wondering what the threshhold is? Thanks Joe >From: nnasheart@... >Reply-To: OSSG-NewEngland >To: OSSG-NewEngland >Subject: HELP >Date: Fri, 16 Feb 2001 15:41:09 EST > >HELP!!! I have received a call from at Dr. Thayers office today. It >seems my insurance has denied my surgery! She is trying to help me make >them >change their minds about it, but I honestly have no hope any more of having >this surgery. My ins. has said that this surgery is " cosmetic " and not >necessary...which I find to be nothing but a pile of dog shit. Like I just >suddenly chose to have major surgery so I could be skinny...What a joke! If >anyone out there has any ideas that might help me.. I would greatly >appreciate any and all ideas. > >Thank you all in advance.... _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 Thank you Dawn..I hope something good comes out of this... T. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 My insurance is Health Care value management... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 Who is your insurance hon? nnasheart@... wrote: HELP!!! I have received a call from at Dr. Thayers office today. It seems my insurance has denied my surgery! She is trying to help me make them change their minds about it, but I honestly have no hope any more of having this surgery. My ins. has said that this surgery is "cosmetic" and not necessary...which I find to be nothing but a pile of dog shit. Like I just suddenly chose to have major surgery so I could be skinny...What a joke! If anyone out there has any ideas that might help me.. I would greatly appreciate any and all ideas. Thank you all in advance.... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 I have HealthCareValue Management/MedTac I called and they told me if was covered if it was medically necessary. I do not know where you worked and I know each plan is different. Mine is watched by MedTac. How much is cobra. Could you not pay it until your appeal is over Re: HELPMy insurance is Health Care value management... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 , I'm so sorry to hear of your shitty day, BUT...like lots have told you, contact Walter L to fight this for you. He's very well known in achieving many positive results from what I've heard. Don't worry...feel free to mention my name to the insurance carriers, I'll be sure to prove this surgery is the BEST thing for the morbidly obese! Dawn HELP HELP!!! I have received a call from at Dr. Thayers office today. It seems my insurance has denied my surgery! She is trying to help me make them change their minds about it, but I honestly have no hope any more of having this surgery. My ins. has said that this surgery is " cosmetic " and not necessary...which I find to be nothing but a pile of dog shit. Like I just suddenly chose to have major surgery so I could be skinny...What a joke! If anyone out there has any ideas that might help me.. I would greatly appreciate any and all ideas. Thank you all in advance.... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 16, 2001 Report Share Posted February 16, 2001 If you saw the info I posted earlier they have paid upon appeal in at least 2 cases. Kshort is on our list with individual emails perhaps she'll post soon for you lyssa Re: HELP My insurance is Health Care value management... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 17, 2001 Report Share Posted February 17, 2001 , My thoughts are with you and I hope this will not be a battle for you. Don't let them discourage you. Pam On Fri, 16 Feb 2001 22:13:52 -0200 " cagriff2 " writes: > I have HealthCareValue Management/MedTac I called and they told > me if was covered if it was medically necessary. I do not know > where you worked and I know each plan is different. Mine is watched > by MedTac. How much is cobra. Could you not pay it until your > appeal is over > Re: HELP > > > My insurance is Health Care value management... > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2001 Report Share Posted February 21, 2001 Hi my name is Carole and I was wondering if you have been approved. I have health care value management/medtac. I called and they said if it was medically necessary. How have you made out Re: HELPMy insurance is Health Care value management... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2001 Report Share Posted February 21, 2001 Carole, I haven't heard a word yet. My regular doctor and I sent a letter to at Dr. Thayers office and from what I understand Dr. Thayer himself will also be righting a letter stating that this surgery for me is medically necessary. One advantage for you though is that I have London Health/Health Care value management. You might have an easier time being approved. Good luck to you... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2001 Report Share Posted February 21, 2001 Carole, I don't work...My husband works at the A & P and this insurance is all new to me. Wow..oxygen. I've heard a few people needing it but just think..after your surgery and some weight loss you wont need anything. I hoestly hope you dont now. I think the London Health is just the type of plan I have. But as far as I know all Health Care values are connected. Well, keep me posted as to what's going on with you and I will do the same... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2001 Report Share Posted February 21, 2001 I hope we both have a chance to get this done. I was just told today that the doctor wants me to have oxygen in the house to use when I sleep. They said my oxygen level was so low. I cannot even think that I could have got to this stage. I do not think I will be having oxygen. I just cannot stand the thought of it. I hope I get approved. Good luck to you also. Where do you work I have never heard of London Health? Are they a managment company to watch over you insurance? Re: HELPCarole,I haven't heard a word yet. My regular doctor and I sent a letter to at Dr. Thayers office and from what I understand Dr. Thayer himself will also be righting a letter stating that this surgery for me is medically necessary. One advantage for you though is that I have London Health/Health Care value management. You might have an easier time being approved.Good luck to you... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2001 Report Share Posted February 21, 2001 I sleep on a cpap machine with an extra machine for oxygen and it really helps alot. If I sleep without using it for a month my color gets bad and I have even less energy...and I heal alot slower. It really helps alot if you need it. Also without it I become enemic. Ick. -- S. Re: HELP Carole, I don't work...My husband works at the A & P and this insurance is all new to me. Wow..oxygen. I've heard a few people needing it but just think..after your surgery and some weight loss you wont need anything. I hoestly hope you dont now. I think the London Health is just the type of plan I have. But as far as I know all Health Care values are connected. Well, keep me posted as to what's going on with you and I will do the same... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 22, 2001 Report Share Posted February 22, 2001 Hi I have the same insurance had my surgery 2/2/01. Payed for it all. I work for A & P. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 22, 2001 Report Share Posted February 22, 2001 ! Tell me...did you get denied at first? So nice to see someone who has the same Ins. as me. Where in Mass. are you? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 22, 2001 Report Share Posted February 22, 2001 Yes I was approved and had my surgery on 12/28/00. Everything is going very well. I have lost about 35 pounds and it has only been 7 weeks today. Let me know how it goes for you. Thinner days ahead, Kim Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 22, 2001 Report Share Posted February 22, 2001 I was never de Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 22, 2001 Report Share Posted February 22, 2001 I was never denied. I live on the lower cape. Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.