Second Appeal for Revision Pending
Kind of venting. Sooooo tired of the process. It's a good thing I'm a creative writer. I have found a gazillion different ways to say "I'm still fat, my sleeve is jacked up, the hernia makes me puke and your appeal reveiwers are heartles*****s."
Well, we just submitted my second appeal. It includes the original 68-page appeal plus about another 5 pages explaining how my lifestyle has changed due to my "redundant" stomach, hernia, etc. I literally have to go on intermittent FMLA due to regeneration in my sleep. I tell you what, sleeping sitting up really blows!
Anywho, I also included the fact that if this isn't fixed, the insurance company will encur substantial costs on a regular basis to treat the symptoms. Starting with doubling my GERD meds, treatment through a gastroentolagist, and ER visits when I aspirate in my sleep. My total out of pocket costs will not exceed $4,600. So the choice is theirs - cover the surgery and regular lab work - or - cover all the other costs that will add up to at least double the cost of the surgery. The one ER visit I had due to aspiration, which led to pneumonia, totaled more than $5k.
Okay, venting done. But these insurance people need to have a heart....oh and give me a freakin' phone number to call! I'm tired of snail mail. If this gets approved, I will be happy to share the love letters sent to my insurance company.
Over and out.
Well, we just submitted my second appeal. It includes the original 68-page appeal plus about another 5 pages explaining how my lifestyle has changed due to my "redundant" stomach, hernia, etc. I literally have to go on intermittent FMLA due to regeneration in my sleep. I tell you what, sleeping sitting up really blows!
Anywho, I also included the fact that if this isn't fixed, the insurance company will encur substantial costs on a regular basis to treat the symptoms. Starting with doubling my GERD meds, treatment through a gastroentolagist, and ER visits when I aspirate in my sleep. My total out of pocket costs will not exceed $4,600. So the choice is theirs - cover the surgery and regular lab work - or - cover all the other costs that will add up to at least double the cost of the surgery. The one ER visit I had due to aspiration, which led to pneumonia, totaled more than $5k.
Okay, venting done. But these insurance people need to have a heart....oh and give me a freakin' phone number to call! I'm tired of snail mail. If this gets approved, I will be happy to share the love letters sent to my insurance company.
Over and out.
Wishing you the best luck ever!!! Keep us posted.
--gina
5'1" -- HW 195/SW 187/GW 115 July 08/CW 121 Dec 2012
******GOAL*******
Starting BMI between 35 and 40ish?
Join us on the Lightweights Board!
DS on Aug 9, 2007 with Dr. Hazem Elariny
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