VERBAL APPROVAL !!! VERBAL APPROVAL !!!
Hello, one & all,
Bear w/me, please, I'm still speechless! First, DO NOT GIVE UP/IN.
I had my first consult w/Dr. Margaret Inman, St. V's, Indy in July of 2005. This was after checking in my insurance brochure, going to their website and thinking I was okay. I want the Duodenal Switch and am having it.
Passed my Psych Eval, did six months, instead of "just" three months supervised weight loss. Was jerked around by my insurance, Mail Handlers.
Finally, after being told by one of their phone personnel, do you realize how big our brochure would be if we put all our exclusions in it, after I said the Duodenal Switch wasn't shown as an exclusion; just rarely used; I realized I was in a world of hurt. Was afraid to switch insurance companies, the term "pre-existing condition" floated around.
Also, I'd talked to two nurses (?) who I had to explain what the DS. They said we've never heard of it. What is it?
I consulted w/Gary Viscio. I decided to retain him for my appeal process. I sent him my entire package on July 14, 2006. He has answered my pitiful, demanding e-mails, talked to on the phone, shared my frustrations and kept plugging away.
I can not praise Gary and his staff enough!!! For, basically, chump change, he took on my insurance company and beat them into submission.
I live approx. 130 miles south of Indy. Each consult at St. V's a major roadtrip. Here's my success story: I consulted w/Dr. Inman (again) November 5. Decided to do the three month supervised weight loss w/Dr. Brooks, St. V. First consult 12/17, second 01/21 plus my psych eval w/Dr. Stotes, third 02/18, fourth/last 03/17. Did the Upper GI, Stress Test, Echo, Hypylori also.
OKAY - DEEP BREATH!! Dr. Brooks' office had allready sent Mail Handlers my weight loss crap. Colleen Obrien, Dr. Inman's offic manager, got a call Fri., 03/28, wanting the rest of my stuf.f. Faxed it to them. Colleen had a verbal approval on 04/01/08, yeah, I know what you're thinking.
I called MH yesterday, wanting a copy of my approval letter in my cynical, hot little hand, was told: you were approved on 03/31, it hasn't been mailed yet. My thought was yeah, that's two whole days, get w/it. I'm waiting until Monday and will call again.
I had no idea how to appeal, deal w/my mean, stone age insurance company, Gary's my knight in shining armor, he did it for me.
Bottom line, do not give in, insurance companies count on us round bottomed people doing that.