Yet another insurance denial.

[Guest guest]

<<

I wish I could say I was post op but alas I am waiting and waiting and

waiting on my insurance company. They denied me because I want to go out

of network so I have submitted an appeal and I am waiting on a decision from

that. I am hoping to get one of the coveted June slots.

>>

Jackie,

Hi I don't get to post much, but I am religious about reading all the posts.

I am having the same problem as you. My insurance company isn't allowing me

to go out of network. I have been through two grievance comites so far. Today

I just got another denial. They are sending me the official denial letter

telling me my options. The agent told me there is one more level of appeal

and if that is denied there is a state appeal. It isn't looking good and I'm

having trouble keeping the faith right now. I guess its time to take a break,

heal my wounds and regroup to fight yet another battle. I hope you have

better luck than I do. (sorry to sound so negative) just feeling down today.

JoAnn ^j^

" Friends are angels who lift us to our feet when our wings have trouble

remembering how to fly. "

[Guest guest]

<< I guess its time to take a break,

heal my wounds and regroup to fight yet another battle. >>

JoAnn,

Time for the Calvary!! I was initially denied by my insurance company, United

HealthCare of Florida, to go out of network for surgery. But I won. I am

very curious to know who you insurance company is, what you have sent them,

etc. One of the keys is to build a case and prove that the surgery that you

and your personal physician want is not available in network. Why don't you

call me and maybe I can share some of what I learned that proved to be

successful in getting them to change their mind. My telephone # is

.

Your WLS Warrior,

Charlan

Florida MGB Post Op 2/28/00

[Guest guest]

,

HI! Do you mind if I call you at a later date and get some info on your

denial? I think I have the same ins.? Let me know! Thanks Margie SC

[Guest guest]

<< HI! Do you mind if I call you at a later date and get some info on your

denial? I think I have the same ins.? Let me know! Thanks Margie SC >>

Margie,

I don't mind at all.

Florida MGB PostOp

[Guest guest]

<< I fear that I might end up facing the same problem. Do you mind if I call

you too and get some info? >>

I don't mind at all,

Florida MGB Post-OP

[Guest guest]

I fear that I might end up facing the same problem. Do you mind if I call you

too and get some info?

>>> Buildart@... 04/12/00 06:27PM >>>

<< I guess its time to take a break,

heal my wounds and regroup to fight yet another battle. >>

JoAnn,

Time for the Calvary!! I was initially denied by my insurance company, United

HealthCare of Florida, to go out of network for surgery. But I won. I am

very curious to know who you insurance company is, what you have sent them,

etc. One of the keys is to build a case and prove that the surgery that you

and your personal physician want is not available in network. Why don't you

call me and maybe I can share some of what I learned that proved to be

successful in getting them to change their mind. My telephone # is

.

Your WLS Warrior,

Charlan

Florida MGB Post Op 2/28/00

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[Guest guest]

Hi JoAnn--

I wish I could offer some tidbit of help but I have none. Just a

good, sympathetic ear (or should I say eye)My appeal has been in the

hands of the doctor who is going to decide on it since the 29th of

March. I called last Friday and they told me that there still was no

answer but one should be coming down at any time. I really don't

know what I am going to do if it is no again. Do I fight? Wait

until we can switch insurance? But if I do wait, next time I might

not be able to get any bypass surgery so should I have an open RNY???

I am sooooo confused and tired from all this. It just begins to

consume your life. I will say a pray for you to muster up the

strength and fight it out!!

Jackie in DE

>

> <<

> I wish I could say I was post op but alas I am waiting and waiting

and

> waiting on my insurance company. They denied me because I want to

go out

> of network so I have submitted an appeal and I am waiting on a

decision from

> that. I am hoping to get one of the coveted June slots.

> >>

>

> Jackie,

> Hi I don't get to post much, but I am religious about reading all

the posts.

> I am having the same problem as you. My insurance company isn't

allowing me

> to go out of network. I have been through two grievance comites so

far. Today

> I just got another denial. They are sending me the official denial

letter

> telling me my options. The agent told me there is one more level of

appeal

> and if that is denied there is a state appeal. It isn't looking

good and I'm

> having trouble keeping the faith right now. I guess its time to

take a break,

> heal my wounds and regroup to fight yet another battle. I hope you

have

> better luck than I do. (sorry to sound so negative) just feeling

down today.

> JoAnn ^j^

>

> " Friends are angels who lift us to our feet when our wings have

trouble

> remembering how to fly. "