Denied approval from medical review for further plastics
But I am appealing!
The medical review takes less than three minutes and although the letter informing where and when to come implies that one can give in more paperwork-that is incorrect!
I will be appealing to Government Medical Complaints Department above all the HMO in Israel.
I imagine it will take me about two weeks to organize myself as I do not have a scanner on my computer so I have to go to a friend to scan all my various documents and then email to myself and open each, save and name each one; do the same with each iphoned and emailed pic; and THEN compose my own personal letter of appeal.
I'm not very computer proficient but I am determined to try my nest to get what I deserve!
The letter of denial claims that my thighs are fat as many obese are -while ignoring the fact that I lost 40K and that my thighs are practically stuck together from groin almost to knee. And my breasts area - although not symmetrical, nor as bothersome for me), but I have dog-ears on the outer edges of my new boobies that especially my left one itches and hurts and under the right is a small area. I wish to also have side boob blubber removed. The medical review claims that the boob issues are all cosmetic. Cosmetic my a**! If I really cared about appearance, I should be concerned about all the scars! Strangely enough the letter of denial had no mention at all of my past issues of delayed wound healing.
They gave me denial last year on the hanging boobs and funus rash and I appealed and won so I hesitatingly cautiously hopeful.
If I do get approval, then my thigh surgery would be a two stage procedure of lipo (1000cc from each thigh) around May-June (Israel works similar to NHS and public hospital under financial medical coverage can be a long waiting list) and the the thigh lift would be six months later.
On another note... I finally saw a new Endocrinolgist who is well renowned also gor her work with WLS patients. I don't have diabetes and my normal fasting glucose runs from 86-97 but my HbA1C before Gastric Bypass was borderline in the graph was 5.8 and now it is low at 3.8 ! The Endo suspects i might have reactive hypoglycemia (i dont feel symptoms) and requests I do a glucose-insulin
(type of gtt) blood tests to which my GP needs to contact the Endo to verify if this test has to be in hospital Day clinic or if it can be done at HMO clinic. Thank Gd it is not urgent.
Mikimi in Israel
The medical review takes less than three minutes and although the letter informing where and when to come implies that one can give in more paperwork-that is incorrect!
I will be appealing to Government Medical Complaints Department above all the HMO in Israel.
I imagine it will take me about two weeks to organize myself as I do not have a scanner on my computer so I have to go to a friend to scan all my various documents and then email to myself and open each, save and name each one; do the same with each iphoned and emailed pic; and THEN compose my own personal letter of appeal.
I'm not very computer proficient but I am determined to try my nest to get what I deserve!
The letter of denial claims that my thighs are fat as many obese are -while ignoring the fact that I lost 40K and that my thighs are practically stuck together from groin almost to knee. And my breasts area - although not symmetrical, nor as bothersome for me), but I have dog-ears on the outer edges of my new boobies that especially my left one itches and hurts and under the right is a small area. I wish to also have side boob blubber removed. The medical review claims that the boob issues are all cosmetic. Cosmetic my a**! If I really cared about appearance, I should be concerned about all the scars! Strangely enough the letter of denial had no mention at all of my past issues of delayed wound healing.
They gave me denial last year on the hanging boobs and funus rash and I appealed and won so I hesitatingly cautiously hopeful.
If I do get approval, then my thigh surgery would be a two stage procedure of lipo (1000cc from each thigh) around May-June (Israel works similar to NHS and public hospital under financial medical coverage can be a long waiting list) and the the thigh lift would be six months later.
On another note... I finally saw a new Endocrinolgist who is well renowned also gor her work with WLS patients. I don't have diabetes and my normal fasting glucose runs from 86-97 but my HbA1C before Gastric Bypass was borderline in the graph was 5.8 and now it is low at 3.8 ! The Endo suspects i might have reactive hypoglycemia (i dont feel symptoms) and requests I do a glucose-insulin
(type of gtt) blood tests to which my GP needs to contact the Endo to verify if this test has to be in hospital Day clinic or if it can be done at HMO clinic. Thank Gd it is not urgent.
Mikimi in Israel
I am so sorry to hear your experience with your insurance company. Keep trying, they will need to give in. Do they NOT SEE THE PICTURES?
Some insurance companies probably want to see blood in order to approve you.
I was denied for a breast left and breast augmentation. I lost so much weight and now I get rashes and my isurance said it was cosmetic.
I saw that you appealed your boobs surgery, do you mind me asking how was the verbage on the letter? I am so not saavy on writing appeal letters. It would really help.
I hope we both get lucky this year. Keep us posted.
Some insurance companies probably want to see blood in order to approve you.
I was denied for a breast left and breast augmentation. I lost so much weight and now I get rashes and my isurance said it was cosmetic.
I saw that you appealed your boobs surgery, do you mind me asking how was the verbage on the letter? I am so not saavy on writing appeal letters. It would really help.
I hope we both get lucky this year. Keep us posted.
YummyMummy1
I live in Israel and the main language in bureaucracy is Hebrew do I wrote in Hebrew like a business letter and my personal account on what I feel.
Also Sunday in Israel is a regular business day so I hope to call the office tomorrow to see where my case is holding.
You are welcome to pm me or email me at mikimi dot steinberg at gmail dot com.
Mikimi in Israel
Also Sunday in Israel is a regular business day so I hope to call the office tomorrow to see where my case is holding.
You are welcome to pm me or email me at mikimi dot steinberg at gmail dot com.
Mikimi in Israel
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