DENIED

But that's not stopping me. I will be appealing as soon as I get the letter. I was denied because Dr K isn't in my medical group's network, but he is in Blueshield's network. I asked the case manager if there was anyone under my medical group just to see what was said, but of course she didn't know. That's because there isn't. I've searched. So how can you not approve something because someone in your group's network doesn't do it, but yet not be able to provide info for someone in network who does? Sound pretty stupid to me, but I just thought I'd give an update. Hopefully I won't end up hospitalized or worse due to one of my low blood sugar episodes before I'm able to get this thing approved.

So sorry to hear about that. Are you with Blue Shield? If you are and he is in the network why do they have a problem? Please keep on fighting and take care of your health, good luck, Carole

Thanks Carole. Yes I'm with Blue Shield. I'm planning on calling them today. I'm hoping they will do like they did last time and submit an appeal for me.

I am so sorry to hear this Monique.  But keep fighting it will come.

I went to my revison surgeon yesterday to ask about having this erny converted to a ds. I was shocked, as he did not refuse to do it!  He said he can, but that I need to get scoped and see what is wrong( lots of burning )  I actually had a hypoglycemic episode about  30 seconds before he walked into the room!  He rushed out and got me some juice.  Is that a ins reason for revision do you know?  I had contacted dr. K, and they said I had coverage, but I wasnt clear if that is an approvel or what...  BUT It is near impossible for me to come up with the 4 k in program fee, and then all the travel cost too... I would have to break into hubbys retirement to come up with all of that. 

He did tell me to go to the pharmacy and ask for some glucose pills and keep them with me.  LOL I think it freaked him out!  Little does he know it happens several times a week to me!

 

That's ok I've already requested an appeal over the phone. In the denial letter they recommended I go to my surgeon or another surgeon here in Sacramento and neither one do the procedure. All I can say is the fight is on.

Yeah I had one on Sunday in Home Depot. I had just had my dinner of fish and salad, but because I had only had coffee all day because I was in church it made it drop when I did finally eat something. It does happen to me a lot. I've gotten to the point that I don't even check to see how low it goes anymore. I guess I should though so I can document how often it occurs. I really can't afford the 4k either, but I'm praying for a miracle.

I'll keep you all posted.