Re: Prayers needed. (LONG)

[Guest guest]

In a message dated 3/12/01 8:42:14 PM Eastern Standard Time,

WhyNot8770@... writes:

<<

I am VERY anxious to hear what possible reason they could use to deny me

this

time.. and hope and pray they just can't.. but just in case.. please pray

for

me.

>>

D,rollin' dem bones for your approval.......good luck, sweetie

joe d

[Guest guest]

If they deny you this time Diane, ask for a meeting with the CEO of the state plan -- and you and your lawyer!! Then get one! They call this kind of bait and switch gameplaying quite illegal in the insurance industry. You should not have to be appealing for their errors and they need to feel some power against them. good luck

Judi in MS

Pre-op Surg on 3/6/01

Dr. Kim/Dr. Booth

BMI 59

[Guest guest]

Diane

I am sending good thoughts your way and hope you get your approval

soon. I know that you have been working on this approval for a long

time. I just know you will have a great outcome on the approval!

Your in my thoughts

> Hi everyone...

>

> I hate to ask this with so much going on with Ellen, Bonnie and

Jeff, etc..

> but I need some prayers.. everytime I see someone post something

about God,

> and Jesus, etc.. I smile and think. that's right with them ALL

things are

> possible.. so I thought I'd ask.

>

> I am in appeal status with my insurance company. they have 30 days

to respond

> to the appeal and that is up this Wednesday (3/14). I am SO

praying I have a

> positive answer about my approval.. and thought prayers ALWAYS

help, so I'd

> ask for some.

>

> For those that don't know my story.. I have Carelink.. my insurance

brochure

> for 2001 says VERY clearly and point blank under " covered

surgeries " .. " Weight

> loss surgery for the morbidly obese, covered 100% " , PERIOD.. no

exclusions,

> nothing needed but a referral from my PCP, which was given with no

questions

> asked.

>

> When my referral went to my insurance company APPROVED by my PCP,

the

> insurance company immediately denied it. The first time because

they said

> they do not cover WLS.. I called them and pointed them to page 24

of the 2001

> brochure where it CLEARLY states they do.. they investigated,

apologized and

> said, You are aright.. HOWEVER, we are going to deny you again (2nd

denial)

> because you want to go out of network for your surgery. I said to

them. .the

> ONLY reason I want to go out of network is because I NEED to go out

of

> network because even though your plan covers WLS you do NOT have

any weight

> loss surgeons IN network.. Again, they investigated, came back..

apologized

> for their lack of knowledge of THEIR plan.. HOWEVER, since the

referral had

> been denied twice eventhough it was through ignorance of their own

plan.. I'd

> have to appeal because their policy states CLEARLY after two

denials (for any

> reason), you must appeal. I told them how convenient that they are

CLEAR on

> their policy in the denial aspect, but do NOT know their policy in

any other

> manner.

>

> Anyway.. bottom line. had to appeal. Sorry that was so long and

sorry to

> those who've heard it and had to hear it again.. but I thought I'd

tell my

> story before anyone asked what my insurance was, etc.

>

> I am VERY anxious to hear what possible reason they could use to

deny me this

> time.. and hope and pray they just can't.. but just in case..

please pray for

> me.

>

> Thanks in advance for your prayers.. and for listening to my

whining.

>

> My prayers to all of you soon to be " post-ops " for a safe and

speedy

> recovery, to you " new " post-ops for a continued successful

recovery, and you

> " old timers " to continue to realize what a true blessing this has

been for

> you .....

>

> Take Care

>

> Diane

[Guest guest]

Diane,

Sorry to hear your having such a hard time. Keep up with your

positive attitude and I will keep you in my thoughts.

Take care,

Brigid

[Guest guest]

" I am VERY anxious to hear what possible reason they could use to

deny me this time.. and hope and pray they just can't.. but just in

case.. please pray for me. "

Sounds like they are trying to wear you out.... little do they know

how determined you are! What BS about having to appeal because of 2

denials when the denials were from their own stupidity!

Best of Luck, please let is know how it goes. Sending you lots of

postive vibes...

mary

corona, ca

bmi 66

consult mar 29 Dr Rabkin

[Guest guest]

Thanks in advance for your prayers.. and for listening to my whining.

Anytime Diane and yes I will be praying for you in this matter.

Kathy

pre op

5' 6" 313 lbs

BMI 50.4

Wife and mom to 8

[Guest guest]

Hi Diane,

You certainly have my thoughts and prayers. I am just about in the

same boat. Today, March 13, is the 15 days for my appeal to be

decided upon. I haven't heard up til now and I am really worried.

The first denial was due to the DS as being

experimental....whatever...I tried to prove that it was indeed not

experimental.

So good luck and let us know.

B

> Hi everyone...

>

> I hate to ask this with so much going on with Ellen, Bonnie and

Jeff, etc..

> but I need some prayers.. everytime I see someone post something

about God,

> and Jesus, etc.. I smile and think. that's right with them ALL

things are

> possible.. so I thought I'd ask.

>

> I am in appeal status with my insurance company. they have 30 days

to respond

> to the appeal and that is up this Wednesday (3/14). I am SO

praying I have a

> positive answer about my approval.. and thought prayers ALWAYS

help, so I'd

> ask for some.

>

> For those that don't know my story.. I have Carelink.. my insurance

brochure

> for 2001 says VERY clearly and point blank under " covered

surgeries " .. " Weight

> loss surgery for the morbidly obese, covered 100% " , PERIOD.. no

exclusions,

> nothing needed but a referral from my PCP, which was given with no

questions

> asked.

>

> When my referral went to my insurance company APPROVED by my PCP,

the

> insurance company immediately denied it. The first time because

they said

> they do not cover WLS.. I called them and pointed them to page 24

of the 2001

> brochure where it CLEARLY states they do.. they investigated,

apologized and

> said, You are aright.. HOWEVER, we are going to deny you again (2nd

denial)

> because you want to go out of network for your surgery. I said to

them. .the

> ONLY reason I want to go out of network is because I NEED to go out

of

> network because even though your plan covers WLS you do NOT have

any weight

> loss surgeons IN network.. Again, they investigated, came back..

apologized

> for their lack of knowledge of THEIR plan.. HOWEVER, since the

referral had

> been denied twice eventhough it was through ignorance of their own

plan.. I'd

> have to appeal because their policy states CLEARLY after two

denials (for any

> reason), you must appeal. I told them how convenient that they are

CLEAR on

> their policy in the denial aspect, but do NOT know their policy in

any other

> manner.

>

> Anyway.. bottom line. had to appeal. Sorry that was so long and

sorry to

> those who've heard it and had to hear it again.. but I thought I'd

tell my

> story before anyone asked what my insurance was, etc.

>

> I am VERY anxious to hear what possible reason they could use to

deny me this

> time.. and hope and pray they just can't.. but just in case..

please pray for

> me.

>

> Thanks in advance for your prayers.. and for listening to my

whining.

>

> My prayers to all of you soon to be " post-ops " for a safe and

speedy

> recovery, to you " new " post-ops for a continued successful

recovery, and you

> " old timers " to continue to realize what a true blessing this has

been for

> you .....

>

> Take Care

>

> Diane

[Guest guest]

You certainly do have my prayers for you! Have you also thought about

filing a complaint with your state insurance commissioner? Most

insurance companies hate having them come into the picture and you

have a very compelling reason for complaint.

P

> Hi everyone...

>

> I hate to ask this with so much going on with Ellen, Bonnie and

Jeff, etc..

> but I need some prayers.. everytime I see someone post something

about God,

> and Jesus, etc.. I smile and think. that's right with them ALL

things are

> possible.. so I thought I'd ask.

>

> I am in appeal status with my insurance company. they have 30 days

to respond

> to the appeal and that is up this Wednesday (3/14). I am SO

praying I have a

> positive answer about my approval.. and thought prayers ALWAYS

help, so I'd

> ask for some.

>

> For those that don't know my story.. I have Carelink.. my insurance

brochure

> for 2001 says VERY clearly and point blank under " covered

surgeries " .. " Weight

> loss surgery for the morbidly obese, covered 100% " , PERIOD.. no

exclusions,

> nothing needed but a referral from my PCP, which was given with no

questions

> asked.

>

> When my referral went to my insurance company APPROVED by my PCP,

the

> insurance company immediately denied it. The first time because

they said

> they do not cover WLS.. I called them and pointed them to page 24

of the 2001

> brochure where it CLEARLY states they do.. they investigated,

apologized and

> said, You are aright.. HOWEVER, we are going to deny you again (2nd

denial)

> because you want to go out of network for your surgery. I said to

them. .the

> ONLY reason I want to go out of network is because I NEED to go out

of

> network because even though your plan covers WLS you do NOT have

any weight

> loss surgeons IN network.. Again, they investigated, came back..

apologized

> for their lack of knowledge of THEIR plan.. HOWEVER, since the

referral had

> been denied twice eventhough it was through ignorance of their own

plan.. I'd

> have to appeal because their policy states CLEARLY after two

denials (for any

> reason), you must appeal. I told them how convenient that they are

CLEAR on

> their policy in the denial aspect, but do NOT know their policy in

any other

> manner.

>

> Anyway.. bottom line. had to appeal. Sorry that was so long and

sorry to

> those who've heard it and had to hear it again.. but I thought I'd

tell my

> story before anyone asked what my insurance was, etc.

>

> I am VERY anxious to hear what possible reason they could use to

deny me this

> time.. and hope and pray they just can't.. but just in case..

please pray for

> me.

>

> Thanks in advance for your prayers.. and for listening to my

whining.

>

> My prayers to all of you soon to be " post-ops " for a safe and

speedy

> recovery, to you " new " post-ops for a continued successful

recovery, and you

> " old timers " to continue to realize what a true blessing this has

been for

> you .....

>

> Take Care

>

> Diane