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RE: Re: RE: Bad News

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In a message dated 1/6/2003 9:02:06 PM Eastern Standard Time,

ldybostons@... writes:

> This not questioning is a hard

> habit to break. I have always been proactive.....even when it cause a

> ruckus at my husbands base or command......but insurance is daunting.

> This is the BIG leagues!Gonna have to get out the BIG guns for THIS one!

*************************

Yes, Insurance is daunting, and frustrating!

I've been denied twice already for a breast reduction, the last time for " no

evidence that the member was placed on any treatment plan for her back pain, "

even though I had a year documented with my Chiropractor. So, I said, they

want a treatment plan? I'll give them a treatment plan! So, I promptly made

3 appointments with different Orthopedic Surgeons. I'll eat my $20 co-pay,

and let them fork over the consult fees, x-rays & all. My first appointment

of the 3 was tonight. He was great, will send me a letter stating it's

medically necessary. Tomorrow is #2, then next week, #3 Ortho guy. My plan

is to get them all on the same page, and go for the gusto. If they have the

balls to deny me again, it's time for the Independent Review Board. I'm not

going away, so they just better be prepared for the fight.

I'm sending you a link to help with those appeals. You can even search by

State...

http://www.patientadvocate.org/index.php?p=190

It's really quite interesting. Also, you guys do know about the Yahoo

OSSG-Plastic Surgery list, don't you? Lots of good info there, too.

in NJ

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You know........since Tricare is Military.....I am not sure what my

options are. Am going to have to look into this more. Unfortunately,

they bring us good little military wives up NOT to question when we are

told something..(OK I will get FLAMED over this......but this was OLD

WAY military.....back when they said if they had wanted the men to have

families they would have ISSUED them!!) This not questioning is a hard

habit to break. I have always been proactive.....even when it cause a

ruckus at my husbands base or command......but insurance is daunting.

This is the BIG leagues!Gonna have to get out the BIG guns for THIS one!

Debbie in Gig Harbor

ladybostons@...

www.paws2print.com

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