Approval Reversed...Can anything else go wrong???

After a approval on April 21 from Medicaid to my doctor, my doctor called to see why they had never recieved the actual approval paper so they could schedule a date and Medicaid informed then that they had reversed their decision yesterday... No explanation... So now I have to wait for the official letter to tell me why and to start the whole appeal process again.... I can't take this... Now instead of a few weeks to surgery I am going to spend my whole summer (and fall and winter)fighting this AGAIN...

Debbie this is Bull Sh-- Keep fighting your going to get there. I know this has you upset. Here is a hug. It will all work out at the end Take Care Barb

The only thing that keeps me going is "everything happens for a reason" ...I can't wait until Monday to find out why it was reversed.....I am SO deflated this weekend... My cabinets were stocked with my post op food complete with magic bullet... My mom is selling her house and moving to Florida and I was hoping to have this done before she left so I had a babysitter while I was in the hospital.....But I am more determined now more than ever to take this to the end.....I just need to take a deep breath and try to get on with my life in the mean time... Thanks so much for your reply... It's exactly what I wanted to say to the Medicaid people but couldn't...

Well I found out why my approval was reversed...This will get you.....I have no comorbities....That's right, I guess we don't count the sleep apnea, osteoarthritis, gerd, depression and of course we don't count the broken ankle that WON'T HEAL...The surgeons office is calling Medicaid tomorrow to go over it with them but I have already requested another appeal hearing.. I told the nurse that if it's that easy for them to approve me and then reverse the approval..that they can reverse the reversal and approve me with my list of comorbitities that she gives them.... I know it's a longshot but what have I got to lose at this point?? Just another set back... The funniest thing was that it was Medicaid that said to resubmit with the ankle documentation... Well thanks for listening to me rant and rave...

Debbie, I am glad you are on them this quick. They are going to give into you. You stick with it. You do need this surgery. You comorbities are very serious. The sleep apnea can kill you. The ankle itself is enough. I sent a prayer for you. I know this is upsetting to you. Just hang tuff you will get there. I cant wait until you do. Vickie and Laura went thru this. They will tell you dont ever give up its going to happen. Hugs your way !!! Barb

Thanks! I guess the most frustrating thing is that they don't let you talk to a real person through all of this...I have to wait for the appeal to state my case and even with the last appeal hearing...they had my information wrong and even after I told them the corrections, it was still wrong on the next denial paper...But I will not give up and I know that's what they want me to do... This is the first thing i have ever fought for in my life..(.Well this and that last piece of food on the table..lol) I even let my husband of 16 years go without a fight...well, that wasn't very hard to do either...But I am so tired of being FAT and miserable...

Debbie I started this journey back in 1999. I was denied and I gave up with out a fight and ended up having all kinds of health problems heart problems. I know if I would have stuck it out I would have been aproved sooner than I did. I just let the insurance company have their way. The husband you can do with out the good health you cant. Just hang in there. Things can only get better from here. I think it is ashame there is no number for you to reach them. That is wrong. Lets hope your Dr office can get to them. So you wont have to go to another appeal. But if you do have to go to another appeal. Tear in to them. Hugs Barb

Just another note to update you...I got the official denial letter today... Reason was I have no life threatening comorbities... This is the same reason I got on the first denial a year ago.... Do these people not keep up with anything??? I got the address for special cosideration committee and I sent them a letter along with my xrays of the fractured ankle and six pictures that show the actual deformity of the ankle and foot from it not healing for three years.... If they can take an approval and reverse it, we will see if they can consider this information and reverse the denial before the date for the appeal hearing......I can only hope...actually hope is all I have left! Thanks for listening!!!!!!

Wow Debbie, I have read your posts about your struggle with this. How disapointing. You're right everything happens for a reason. You have certainly been tested with this struggle. Can you move with your kids? I heard KY approves much easier.. or what about FL with your mom? Anyway, hang in there.... Fight Peace, Pam