Play their games and hopefully .....................
Morning All:
Well after a rough few days I am back, some what. lol. I got so frustraited on Saturday with this whole insurance thing that I cried for about 3 hours. Getting confliciting directions from the insurance company and getting the news that I may need to have the knee replaced sooner than thought and possibly being forced to have it done in a less than optimal situation. I just curled up in a ball and balled out loud.
But as everyone has said, my self included, that I knew going in to this it would not be an easy task fighting the larger entity.
I admit It is not a treatment issue, basically. However the issue of wls not being a covered service makes me feel like that denying to pay for life saving surgery is a MEDICAL DECISION.
As Zell has said they are making me jump through hoops and I need to have the attitude that I will jump through them, do everything they tell me and play thier games. Most likely when they realize that I am not going to go away and an independent medical review hopefully decides that the surgery is medically necessary then it will happen.
this brings me to mail I got on Saturday from UHC.
I got one letter that was a breakdown of the phone calls that I had made to them regarding coverage for wls.
The next one instructed me to file for an independent medical review with the California Department of Insurnce.
Now the first letter I recieved from UHC said to contact Maryland Health Education Advocacy Unit and Maryland Department of Insurance. Hence the conflicting instructions. So what did I do? I sent a package to California Department of Insurance for Independent Medical Review, I sent the Attorney Generals Office Health Education Advocacy Unit the information that they requested. And also sending Maryland Department of Insurance request for investigation.
So somewhere I hope to succeed.
One day at a time, Play thier games and hopefully ..........................win
Zells_lori is'abuddingrose'
Well after a rough few days I am back, some what. lol. I got so frustraited on Saturday with this whole insurance thing that I cried for about 3 hours. Getting confliciting directions from the insurance company and getting the news that I may need to have the knee replaced sooner than thought and possibly being forced to have it done in a less than optimal situation. I just curled up in a ball and balled out loud.
But as everyone has said, my self included, that I knew going in to this it would not be an easy task fighting the larger entity.
I admit It is not a treatment issue, basically. However the issue of wls not being a covered service makes me feel like that denying to pay for life saving surgery is a MEDICAL DECISION.
As Zell has said they are making me jump through hoops and I need to have the attitude that I will jump through them, do everything they tell me and play thier games. Most likely when they realize that I am not going to go away and an independent medical review hopefully decides that the surgery is medically necessary then it will happen.
this brings me to mail I got on Saturday from UHC.
I got one letter that was a breakdown of the phone calls that I had made to them regarding coverage for wls.
The next one instructed me to file for an independent medical review with the California Department of Insurnce.
Now the first letter I recieved from UHC said to contact Maryland Health Education Advocacy Unit and Maryland Department of Insurance. Hence the conflicting instructions. So what did I do? I sent a package to California Department of Insurance for Independent Medical Review, I sent the Attorney Generals Office Health Education Advocacy Unit the information that they requested. And also sending Maryland Department of Insurance request for investigation.
So somewhere I hope to succeed.
One day at a time, Play thier games and hopefully ..........................win
Zells_lori is'abuddingrose'
never settle for less than you deserve and you deserve only the best. 
Lori I do hope you win this is so sad to think you are trying to get healthy they say no. Makes no sense to me.. I also wanted to tell you that I finally got my son up in the attic and he can't find the box that had the larger size clothing in it. I will have him look again when he has more time but I did not want you to think I forgot. If I find the box I will let you know ASAP...Good luck on your journey I will say a prayer that things work out in your favor..
Julie
Julie
Julie:
Thanks for all of your support. We will see what happens. Right now I have no expectations.
When/if your son finds the box that is fine.
All prayers and positive thoughts are always appreciated.
In the mean time I will try to continue to do what I need to in order to stay healthy and positive.
I will keep you up dated as how things are going.
hugs from baltimore
Zells_lori is 'abuddingrose'
Thanks for all of your support. We will see what happens. Right now I have no expectations.
When/if your son finds the box that is fine.
All prayers and positive thoughts are always appreciated.
In the mean time I will try to continue to do what I need to in order to stay healthy and positive.
I will keep you up dated as how things are going.
hugs from baltimore
Zells_lori is 'abuddingrose'
never settle for less than you deserve and you deserve only the best.
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