update on apeal

abuddingrose
on 7/31/09 4:53 am - Essex, MD

Tia,Nessa, Cira and everyone else that has been supporting my fight for what i need. I have found light at the end of the tunnel. I must first follow the appeals process and if after two appeals I am still denied I am entitle to an Independant Medical Review. Below is the statment verbatum from the California Department of Insurance.

Under the Independent Medical Review process, one or more physicians will determine these issues and their decision will be binding on the insurance company.

Have a great week end every one.

Ciao

Zells_lori

never settle for less than you deserve and you deserve only the best.

Cira S.
on 7/31/09 4:59 am - Charles Town , WV

RNY on 03/06/07

Woooo hoooooo girl keep your head up!

((((hugs)))))

I am who I am and accept my feelings wholeheartedly.
Those that mind don't matter, and those that matter don't mind.
Cira 249/144.0 current/goal 154/ 5'3" 10 lbs below my Dr's goal
100Cira-1.jpg picture by negra266

(deactivated member)
on 7/31/09 5:00 am - Middle River, MD

RNY on 08/02/05

Cool!!! This sounds similar to a "peer to peer" review!

Hey, whatever it takes, as long as you get approved!!!!

I know you will, but make sure you keep detailed notes. You never know when you'll have to refer to them!

Hugs,
Tia

(deactivated member)
on 7/31/09 5:01 am - Elkridge, MD

RNY on 10/30/07

That's how my approval came through. UHC denied me 3 times and then the idnependent review doctor said I should get the surgery and they had to cover it. GOOD LUCK!

abuddingrose
on 7/31/09 5:38 am - Essex, MD

Sylvie:

Just curious since you mentioned it..... How long did the whole process take for you ?? ie from first appeal to approval?

Thanks for all of the support

Ciao

Zells_lori

(deactivated member)
on 7/31/09 6:01 am - Elkridge, MD

RNY on 10/30/07

Around 3-4 months. I can't remember. I know I started in July, going to the seminar and my surgery was October 30. So, maybe the 2.5-3 months in between.

(deactivated member)
on 7/31/09 6:01 am - Elkridge, MD

RNY on 10/30/07

but that was total, so the appeals process, maybe half of that time?

abuddingrose
on 7/31/09 6:05 am - Essex, MD

Sylvie:

Thanks for the quick response. I had the same time frame in mind. If all goes well. (keeping my fingers crossed). Since my original surgery date is September 8, 2009. I am going to figure about
December. That would be a great Christmas and aniversary gift . My bf and I will be together three yrs.

enjoy your week end

Zells_lori