Question:
I got my first Denial letter in the mail today...........

I called insurance to get more details. The case manager I talked to went over things that I would need to meet and obviously records were not sent to her. 1st thing I do not currently meet is Hypertension with a Diastolic over 100 consistently. WOW, isnt that really HIGH? I only have my blood pressure documented on a few of my records and some are close maybe 148/90 or 138/85 are examples. But neither one are over 100. What can I do???? 2nd is Full trial of lipase inhibitor. At my gastric consult the doctor said he could probably document that this would not be an option for me because I have severe diarrhea from Metformin (diabetic medication). Would him saying this help qualify me?? I do not have diabetes, but am pre-diabetic, They put me on this medication for polycystic ovarys and my chart clearly says it is for this. 3rd item is hyperlipedemia with cholesteol over 300., I can not find in my lab work that I ever had this done, so what do I do about that??? 4th item is diabetes with medication control, Well, as I stated I am on the medication which is used for diabetes, and I am termed pre-diabetic (one lab came back elevated, but they never did another one until after I was on the medication already so it was down = which equals not having the diagnosis.) 5th is joint pain with evidence of degenerative changes by X-ray. Well, I have never had an x-ray done that I can think of - so will getting one now and hoping for something help? I have been to a chiropractor many times because of back pain and have clincal documentation from doctor with knee pain, Ugh, I am so discouraged, but plan on getting this covered, I need to. I have set up a pysch evaluation for next week because they require that and insurance will cover (so thats good, gotta get it out of the way). Please give me some advice, I need help and feel so useless - I want to be a big SKINNY LOSER! Kristie [email protected]    — Kristie M. (posted on August 14, 2002)

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