What's On Your Tuesday Menu, RNYers?
Thank you! The crazy thing is I'm on two different PPIs and they also had denied coverage for one of them. We finally, finally got them to agree to cover my meds, but that took an appeal, a Peer to Peer review and a threat of the Department of Insurance involvement. I'm so glad that your insurance agreed to cover your meds! It was quite a relief when I got that call.
Seriously the DOI denied because you hadn't appealed?? Yet your insurance plainly stated you have no right to appeal? Bureaucracy at it's finest. Do you think the Insurance company just puts that there so that 98% of the population will believe without questioning? Ugh... ethics people. FIGHT LIKE HELL!!
I understand your need for variety. I had issues with that yesterday (and today too). I ate chicken skin today! (I have not since surgery, too fatty for me) just cause it was something a bit different. I over-dosed on the coffee yesterday but I must admit I am really looking for to my afternoon coffee today. Just a touch of sweet will be nice after all this savory.
34 g carbs is nothing when you look at your protein numbers! You are rocking this lady!!
You understand the DOI's position correctly. I can't have an independent medical review because I didn't appeal the non-appealable decision. I think your second point is right also, they make it difficult so the average person will just go away. I was talking to my surgeon yesterday who said he wants to get a study going with surgeons from across the country to try and get this procedure approved for post sleeved patients. He made a comment that we're lucky I practice this type of law and understand the process because the typical patient would get the first denial letter and just accept it. He'd like to use my experience to help other patients down the line. I told him I'm all about paying it forward so I'm behind his efforts 100%. We talked about converting to bypass (which my insurance company has already approved) but he said since we're on this crusade, would I be OK with continuing on the fight and holding off on surgery. I said yes. At this point, if I want to see it all the way through the DOI, I have another 60-90 days before anything happens.
I didn't have any coffee yesterday. My concern is (and I'm sure this is all in my head) I usually have something with carbs (usually a greek yogurt) before an exercise class or a run for extra instant energy. I don't know what the extra protein will do to me. That's one reason I got coffee today . . . I knew it would be higher in carbs because of the milk . . . and it was FREE!!!
awwwww that royally sucks about the GERD! Hey if you move here its all OHIP (Ontario Health Insurance Plan) and you won't have to deal with Insurance companies, the pluses keep adding up to move here! LOL LOL
On a serious note, I am sorry to hear of your struggles, I can't even imagine the pain and frustration!
Just so you know I was in the same boat last night, I was not hungry, I was totally full but I felt like I needed something other than steak for dinner. Totally my mind playing tricks on me cuz I was not hungry, so I get what you mean.
I am glad you are a Lawyer and can talk the talk and I have my fingers crossed you can kick some ass!
Thinking of you, hugs!
Canada is looking better and better!
I am very grateful I'm a lawyer who practices insurance law! I know I said it before, but I'm truly grateful for my surgeon. He believed me when I first started showing signs of GERD and wouldn't stop, even after my first test came back negative. He called me and the first words out of his mouth were "I believe you." I would not be as into the fight if I didn't have him right beside me.
