Update on my Appeal - Page 2 - ThinnerTimes

Dorothy · 02-23-2006, 05:55 PM

I am so sorry you are going through this! I hope it all works out for you!

Rubyhawk · 02-23-2006, 10:37 PM

Quote:

Originally Posted by Tawanda

Well, the insurance finally called me back yesterday and they upheld their original decision to deny my surgery...Ack!

I have one more level of appeal and they said I should be getting the info on that in the mail this week.

Besides being really, REALLY disgusted....I am madder than a wet hornet!! I am thinking that it is time to see an attorney.

Does anyone know anybody that has gone to an attorney for representation to the insurance company? I only have another 30 days to appeal the second time and I am thinking I need to bring out the BIG guns.

Twanda - I to lost out on the insurance 4 years ago. I gave up. Now here it is present day. I decided in November of 05 that I had enough of living my life in misery. So I was determined to get this done once and for all. I must say that it takes a good PCF that will push the insurance company. That’s what my doctor did and he got them to change their mind with one appeal this time. I don’t know who your insurance company is but I do know that If your doctor lets them know that it is time sensitive to your health to have the surgery ASAP they tend to approve the procedure. I hope this helps. hang in there.

Tawanda · 02-24-2006, 11:00 AM

Justa,

I'm sorry you're going through this, too. But I guess I feel a bit more outraged because my insurance (Starmark) doesn't totally EXCLUDE the surgery (like yours does?)...they are just making it so darned impossible to qualify that it might as well be an exclusion. Why don't they just go ahead and exclude it so that a person doesn't get their hopes up? Argggghhhh.