OMG!! FINALLY approved!

After only a year...(grrrr) Medical Mutual of Ohio has FINALLY approved my RNY surgery! I just got off the phone with MMO. They said their director read my file and OVERTURNED their recent denials. Let me tell you people still waiting and fighting....KEEP IT UP!!! I was denied the last time on Sept 10, 2004. I figured it was just not meant to be...I pretty much gave up until I read somewhere about an attorney named Gary Viscio. I emailed him and he said he could handle my case and thought he could win. In the meantime I read someone's post who had hired him and still been denied. I decided to complain online to the Ohio Dept of Ins. I did, and soon I received a call from them stating I had never asked for my case to go to an External Review board outside of MMO. They said I needed to do it ASAP, as I only had 180 days from last denail date of Sept. 10, 2004.....yes that meant I had until Mar. 10...YIKES!!! I faxed a letter to Medical Mutual and told them I wanted the Ohio Dept of Ins to get involved in my case by means of an External Review on TUES. Mar 8th. TODAY, I got the call from MMO that my denial was OVERTURNED by the director at MMO and I should call my surgeon and schedule the surgery, they were mailing out the letter of approval today! I see my surgeon on Tues, almost a year to the day from when I had my initial consultation! His nurse said I may get in for surgery as early as April 12th! Do NOT WAIVER!! Be thorough and consistent. I wish everyone who is waiting or fighting the very best and if I can ever do anthing to help any of you, let me know!! Please contact the Ohio Dept of Insurance if you have exhausted all other means! They're great, and want to help you! Best of luck to all, Pamela B

That is wonderful... I am doing the happy dance at my desk You go girl!! Keep reaching for the stars!!

Aw, thanks Paula!! You look lovely in your photo, BTW!! And that's BEFORE surgery??? You go girl!!! LOL!! Pamela

CONGRATS Good luck and never underestimate the power of persistance! i hope all go's well let us know. Cindy

Congratulations!!!!!!!!! I look up to you as I try my second appeal. I pray you breeze through surgery. Luann

Don't give up!! I am sure it's gonna happen for you!! Of course, I'll believe it better when I have that approval letter in my hands! LOL! Don't forget about the ODI, if you need them!! The lady who called me from there was so nice and helpful! Best wishes for you! Pamela

Yeah that is great news!! I am very happy for you!! It sounds like persistance is the name of the game!! Thanks again for your help with my medical record stuff (I got my record)!! Take Care - Stacey

Oh Stacey! I'm so glad! I wondered if you were able to get it! Don't worry about anything right now...just make and keep your appointments...it's all about the hoops you have to jump through!! *sigh* Please keep me posted on how you progress!! Pamela

Pamela, Congratulations! I know you must be very excited, ( and exhausted ) after all of the fighting you had to do. I am so very happy for you. Good luck on your upcoming surgery! Be Blessed~

Congratulation!!! I know you must be higher than a kite right about now!!! I, too, have Medical Mutual of Ohio and have been at this since last August/September timeframe. What a mess!!! At any rate, I found out earlier this week that my case finally made it back from the outside consultant. The outside consultant recommended to MMOH that I see their psychologist for testing and consultation..... my appointment is this upcoming Monday. I am a little nervous, but feel that this might be a good sign!?! At least the outside consultant didn't flat out deny my request for RNY. What puzzles me, is that I already had a full-blown psychological eval back in either August or September and was recommended to have the surgery as a result of the review. Why does this psychologist have to do more testing??? Or, is it that it is standard operating procedure at this point to have it done again by an actual "contracted" psychologist??? Any insight or suggestions would be greatly appreciated!!! Thanks and, again, CONGRATULATIONS!!!! I hope to be where you are at VERY SOON!!!! Hugs, Karen