Re: Digest Number 815

[Guest guest]

In a message dated 2/29/00 6:06:11 PM Central Standard Time,

MiniGastricBypassonelist writes:

<< FYI-- I saw that 60 minutes is having an attorney on tonight who is taking

on

the HMO's who deny care. It is the same guy who took on the tobacco

industry

and won. Maybe if we all watch and write letters one will get posted the

next week about MGB and how insurance companies treat the obese. Just a

thought.

V >>

This is a Wonderful idea......I wonder if it would be possible to DELUGE 60

minutes with letters???E mails....Phone calls.......How can we get the word

out QUICK to EVERYONE that is trying to get insurance approval? Sounds like

we need mass emailing to all the docs that do the surgery...But if they drop

the ball(ie not notify all their patients) then I guess they would be CRazy

not to make this a Huge(no pun intended...for those of you with sick

humor....lol) Opportunity. I think it is time we make a statement. Come on

guys lets do it!!!! Just tell me what I can do to help.? If anyone has some

addresses or say the top 5 that do lap////////and the " Others " I will write

to them this week and give them a heads up on the program and ask them to

have their patients watch and write to them(Ie 60 minutes) If we could make

this the Guiness book of world records response to a show on Tv....we would

NO doubt garner a MENTion on the program the following week. Baby

steps...........then we have a jumping off point. Ophrah next. We can call

her and tell her what we did.....and then we can ask her to interview some of

the recipients of this Miraculous life changing event. I am preop but I can

envision also her interviewing a couple of preops also(Not me no thank you I

am allergic to cameras) This would also generate MORE interest (an

explosion...if that has not already happened due to the interest sparked by

Carnie and RoseAnne Barrs operations)

I personally think it would be GREAT to just to the Dr Rutledge patients.

However ,he is just one man and could not Possibly do all the persons that so

desperately need this life saving procedure. IF we could persuade someone

like Oprah to do a " series " on Morbid Obesity for a whole week just IMAGINE

how quick we could get our congressman to put some pressure on the insurance

companies. We need to go after ANY way we can change this fight everyone has

to get the surgery. We need to convince them that the time we are waiting

PREop can be spent more wisely educating ourselves about the surgery and

getting ourselves mentally, emotionally and spiritually ready for this modern

day miracle. We also could do better in the hospital if we could eliminate

the FEAR and anxiety that many have about concerns that the insurance will

NOT pay or change their minds, etc., and leave them with a bill that would

financially devastate them. Postoperatively we could SHOW them how much of a

contribution we could make to society with our renewed energy and daily

improving health.

Anyone that wants to help me please e mail me or direct me to someone who is

a super organizer and can get this going....

/Oxford Ohio

Preop pending insurance approval

Willis Corroon Administration Services-( self insured company)

Dr R I need a date???lol

[Guest guest]

In a message dated 2/29/00 6:06:11 PM Central Standard Time,

MiniGastricBypassonelist writes:

<< I asked her to

fax to the information again to a second number after BC/BS said they

had lost the first set of papers. I called the insurance company at

least four times in ther past two weeks and they still do not have

it. All they have done is give the fax number they gave to me to

start with and said try again. Has anyone else had this problem? I >>

I have had this problem. My insurance is through a privately insured company.

They have Willis Corroon administer their policies. They received the request

from Forest health Services in Ann Arbor Michigan. (They do the

preauthorizations for The Bariatric Treatment Center in Columbus Grove Ohio

[where I went last September) The preauthorization coordinator assigned to

me spoke to them and I spoke to them within the first two weeks of the letter

being sent and they were sending it for " medical review " .

Two weeks later I spoke to them and they had no idea if they had even

received ANYTHING from my doctor. Luckily I had written down the name of the

person that both myself and the preauthorization coordinator had spoken two

prior. Even though I had a name they tried to make me THINK that they did not

have it and almost tried to act like there was not a person there by that

name until I confronted them with it. Confrontation has to be used in a nice

way with insurance companies though unless you want your claim to end up in

the trash. Maybe that is what happened to mine. Actually I have a theory that

they are getting paid by how much paper they can recycle.lol.

At this point I found out that they dont even look at my request ....it has

to go to a company that does contract work for them......MEd Track.......The

people at Med Track are SO MUCH nicer. I did find out later that they are in

the same building....They claim NOT to be owned by the same people....I find

that laughable. I can just imaging they have a quota too meet if they do not

have any other affiliation in ownership or management.

Although it was not COMMUNICATED to us to Send the stuff to Med track....it

took another couple of weeks to find out that MEd Track had NOTHING on me.

All of this I find by just calling and asking what Information I might

provide them to help them in their decision. By the way there is supposedly

and exclusion policy but they have not mentioned it to me. The only person

that has was the first person I called to ASK if it was covered and she said

" is this for weight loss " and I said no....it is for morbid obesity and she

said " it is not covered!!!! " Like she has the power to make that decision so

abruptly. I think not...........

Anyway....Med track tells us we are " not in their system " A previous comment

I \had heard from Willis Corroon after calling to check on the status( As

mentioned above)

They said if someone (IE someone other than Willis)did not give them

identifying information about me that they would have not recognized ANYTHING

that was RESENT from the doctors office(Forest Health Services). She admitted

that they would have thrown it away//////How about that? I asked if they

would try to refax or notify the person who sent it and she unconvincingly

said.... " yes " ROFLMAO.

Even though Willis would need to have a medical review they do NOT forward or

even TELL you that you have to send something and Call Med Track. How is that

for red tape?

So we resent it. They received it and I am calling at least every other day.

So far The nurse took one week to talk to someone at the doctors office .

Then she " forgot to ask " because she " assumed I already had " medical and

psychological clearance. That I am working on now. You have to pull teeth.

You have to write down names and make people accountable. I had a nice person

at Med track that Gave me a tracking number(AFTER I asked for it) This helps

a lot. You need to do the work because is is impossible for the doctors

office to babysit all of these claims and insurance companies. We need to

make them accountable to THEIR client. US....the ones that pay the insurance

bills...

/Oxford,Ohio

BMI 46.1 Preop

Pending insurance approval

Willis Corroon(private insured)