Called in the "Big Guns" - ThinnerTimes

Baron Patrick · 01-19-2007, 12:03 PM

First I want to thank all of you for your support to my emotional missive. I'm feeling better, but still can't believe all this. You do like me, you really, really like me!

I really do appreciate the support. You have all been so patient with me (jeez, it's only been like what, 2 years!?)

I called my surgeons office to let them know what's going on. I told them the only things I'm lacking (according to the ins. co) is a report from the dietician (of which I received the referral and making the appointment), and the 6 month followup with my doctor. They told me to contact the state's Department of Managed Health Care. I did, and they said I do have a legitimate complaint, and have started a file on me.

They are sending me a packet this next week to complete and get back to them ASAP (just what I need, more paperwork).

Now, here's the deal. The state agency has 30 days to do their research and contact the insurance company. The insurance company then has something like 3 days to comply with their findings (which is mandated by law). So, in other words, if the insurance company is told I qualify, then they have to approve me. Note - the surgeons office is very much aware of this insurance company, and every person who filed a complaint was approved for the surgery. It's my understanding the 6 month "rule" is not required in California, and that's the only sticking point.

I also asked the surgeons office about my pre-op. The chest x-ray is good for six months (so I'm good till April). However, I will most likely need another EKG.

So, there it is, that's where I'm at right now.

Thanks!

eyesthatkissu · 01-19-2007, 12:24 PM

I keep picturing you on a horse, brandishing a sword screaming, "I will be vigilant I shall overcome!!" It suits you!!! I can feel it coming... finally an approval! *waits with baited breath* (can I sue them if I die from lack of oxygen?)

Zenomia · 01-19-2007, 12:36 PM

Quote:

Originally Posted by eyesthatkissu

I keep picturing you on a horse, brandishing a sword screaming, "I will be vigilant I shall overcome!!" It suits you!!! I can feel it coming... finally an approval! *waits with baited breath* (can I sue them if I die from lack of oxygen?)

I can see this too...or In a KILT...on a hill brandishing a sword with blue and red painted face...Screaming in Gaelic....while running down the hill, wind sweeping the long braids....eeegawds...I need a life! Sorry bout' that...mind drifts at my age...hehehe

I will be waitin' right along with everyone else...It will surely go through THIS TIME!!!! <<Crossing fingers, toes, legs, arms...pretzled myself...

)

eyesthatkissu · 01-19-2007, 12:45 PM

LOL Zen!! "They can take our lives... but they'll never take our freedom"?? Or maybe "They can tell me no, but the can't tell me never!"

Zenomia · 01-19-2007, 12:46 PM

Quote:

Originally Posted by eyesthatkissu

LOL Zen!! "They can take our lives... but they'll never take our freedom"?? Or maybe "They can tell me no, but the can't tell me never!"

ROFLMAO!! YES, YES, YES!!! Hey, I'm not alone on this train of thought! WOOHOOO!

coptergirl · 01-19-2007, 12:47 PM

Us girls with our vivid imagiations

Good going, Pat on calling in those Big Guns to apply the pressure. Now...how many visitors are you allowed at one time in the hospital - any way they can reserve a floor just for you, 'cause so many of us would come to see you that we would need the floor to party along side you in your morphine haze

LyndasRoom · 01-19-2007, 12:49 PM

Patrick...we do like you, we really do! I'm so glad you've found another avenue, and an advocate. At our support group last night, Kelly, the Nurse Practitioner for Dr. Callery's & Dr. Potts' office was telling us that starting this year, all of the insurance plans are going to require the 6 month supervised diet. All together now...ARGH!!!!!!!!!! but at least now, there won't be a question. I'm glad you have a good dialogue going with your surgeons office, it can make all the difference. I admire your strength and perseverence!

LisaBoston · 01-19-2007, 04:40 PM

The day your surgery comes (and it will!) You will hear me hooting and hollering all the way from Canada!

bridgetgirl · 01-19-2007, 04:52 PM

I cant wait to have you on the losing side... we have been keep the bench warm for sooo long were starting to get splinters on our tush! But I will do it for as long as it takes!

I will be dancing in the streets, the day I hear APPROVAL and SURGERY DATE! I cant wait!!!

You go boy!!!! (( HUGS ))

Duckie · 01-19-2007, 08:46 PM

Can I dance with you Bridget? I can't wait for the big YES day!!! Go Patrick! Go Patrick! This IS IS IS IS IS going to happen for you!