Appeal After Appeal After Appeal!
Nothing has changed with my City Insurance since before the lap band surgery. I was turned down twice in 2005 - each time for a different and changing reason and they are doing the same thing to me all over again! 
First they say that they never got records that the doctor's office faxed them. My doctor's office faxed them over 30 pages of clinical data but Care Allies must have just decided to lose selected pages... Then they decided that since I had an Rx for Protonix that I no longer have reflux. I JUST HAVE IT 24 HOURS A DAY!!! They don't care that my BMI is over 40 and slowly climbing back up. They don't care that I still have high blood pressure, type II diabetes, arthritis and have not had a moment without this reflux since Easter Sunday!!! Yesterday would have been my surgery day, instead I mailed my external appeal to the New York State Department of Insurance. I am sick and miserable and they couldn't care less. They just want me to forget about it or die so that they don't have to pay for my surgery... I can't let them get away with this. I deserve to have my band removed and I deserve a revision to RNY. Tomorrow I have an appointment with a new gastroentorologist. Maybe he can think of something. Better yet maybe he can prove that my band is causing all of this pain and burning. This is no way to live.
First they say that they never got records that the doctor's office faxed them. My doctor's office faxed them over 30 pages of clinical data but Care Allies must have just decided to lose selected pages... Then they decided that since I had an Rx for Protonix that I no longer have reflux. I JUST HAVE IT 24 HOURS A DAY!!! They don't care that my BMI is over 40 and slowly climbing back up. They don't care that I still have high blood pressure, type II diabetes, arthritis and have not had a moment without this reflux since Easter Sunday!!! Yesterday would have been my surgery day, instead I mailed my external appeal to the New York State Department of Insurance. I am sick and miserable and they couldn't care less. They just want me to forget about it or die so that they don't have to pay for my surgery... I can't let them get away with this. I deserve to have my band removed and I deserve a revision to RNY. Tomorrow I have an appointment with a new gastroentorologist. Maybe he can think of something. Better yet maybe he can prove that my band is causing all of this pain and burning. This is no way to live.
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