Huh?

I called my insurance today and asked what the status was on my appeal. I was told that my information was sent to an outside consultant. I said what does that mean and she said "Its a dr affiliated with us to approve or deny you." --- What does this mean? Is it fair for a dr who has never examined me or knows nothing about my history able to do this? My PCP and my surgeon have already written letters and are way more qualified in my situation to determine this... Anyone else have this happen? Please!

That is basically what disability does. They have drs who go over your files and say whether you are disabled or not. I hope you get a great honest one and are approved in record time.

Disabled? I am not disabled? What do you mean?

No dear, I am disabled and that is how they do. They send your records to an outside dr and he decides your outcome. I was just letting you know that there are many other instances where an outside dr has the say so whether he has never laid eyes on you or not.

OHHHH....

When I appealed in Pearl River County they sent my records to a consultant in Laurel. He said I did not seem to be a good candidate because of my depression/ My doctor of 15 years said I was and had been pretty stable for 8 years. That is from the dr. that knows. So I kept pressing on and I am now the step before getting a date. Monday I go to my appt to a psychologist and he will release my records to the surgeon Dr Blake and I will get a date. Iam finished with everything else. Do attend any type of support group. The Dr wants me to and I dont' want to drive to Jackson. Thought about the coast or FGH. I am going to check to see if FGH has a support group yet for their surgery candidates. It seems ignorant for them to send it to an outside person but they do. Jane from Poplarville MS

Hi Jane... We have a support group meeting coming up this monday at the Rennasaice Center behind FG. Please come. Its at 6 or 6:30. I will find out for sure. Would love to meet you. I am so nervous about this. They didnt send my first request to outside consultant. Why this one?

I dunno, but I will give you a hug and smooch to calm your nerves... ((((((((((((((((((((((((((((((((((Christine))))))))))))))))))))))))))))))))))))) Smoochers, Arlies

Also happened to me. It must be fairly common. My insurance is with Pittman and Ass., but my records went to Value Check for the approval/denial process. I was denied the first time for not having documentation for a sustained effort to lose weight (incredible) within a medically supervised program. I actually had about 18 months or more documented and only needed 6 months, so I had to make a number of calls to Pittman and to Value Check to get them to recheck my files. I finally got approved and had my surgery on 7-26=04. Hang in there and don't take no for an answer. Ask why and what kind of documentation your insurance company requires.