Rocky Mountian HMO C-1000

Ruth D.
on 10/16/03 8:05 am - Delta, CO
I am still fighting with this insurance. I have had both my PCP and the surgeon that I have been refered to for a reacurring hernia problem recomend this surgery for me and write letters to the insurance company telling them that I have had a recurance of hernias for the last five years and one even stated that it was medically necessary for me to have this proceedure. and they have still declined me. I have had 8 surgeries in the last 5 years and 7 of them included a hernia repair. Now I am suffering with more (multiple More). Plus I have a residual infection around the mesh from the last surgery with a fistula that has chronic drainage, so to go in and do another traditional repair would not work. They would have to remove all the mesh to get rid of the infection. Then I would be back at square one. But, to have this proceedure and loose all the weight, I might be able to have a tummy tuck and have the repair done with no mesh. NO MESH, NO INFECTION. But, because of the exclussion, they won't consider it. I have put in for the hearing and the surgeon who has done most of my hernia repairs is back from the war, so I am asking him to write a letter to go with this. I am going to fight this one more time at least. But, Does RMHMO ever okay this surgery? Has anyone with this insurance had them pay?
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