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on March 23, 2008 8:44 pm
I feel I have met all insurance requirements and have completed my six month diet program. I am going to mail my appeal letter this week. Please keep me in your prayers...
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Kellie1267's Blog
Going to appeal... wish me luck !! on March 23, 2008 8:44 pm
Back to square one... on March 13, 2008 8:36 pm Well today I went to my Primary Doctors office to get a copy of the Denial letter from the Medical Grp. I wanted to find out more as to why they denied me so that I could get started on my appeal letter.. Well honestly at this point there is no need to appeal. They did Deny- Medically not necessary BUT it also says to resubmit after my six month diet program has been completed..WHAT ?? I did that..... every month for the past 6 months Ive gone to see my doctor, weighed and talked about my progress... two of those six months (nov. and dec.) I consulted with a Dietician.
2 comments | Click here to leave a comment.Well I guess I was supposed to not only see my PCP, I was supposed to see a Nut/Dietician the whole six consecutive months... Great !! Im angry at myself for not understanding this requirement but Im SUPER angry at my Doctors office for not instructing me to do this... I think I basically have to start all over ..... question is, do I find a new doctor ?? and this is strike three on Doctors.. How do I find the right one ?? Anyhow,, thats where I am today .....SOOOO extremely frustrated and Depressed !!
Denied !! on March 12, 2008 8:21 pm Because I hadn't heard from my Medical Group, I decided to give them a call today to see if they had made a decision...I was told that I was "Denied". When I asked why, all she could tell me was "not medically necessary" and I would need to get more information from my PCP. She said she would fax the info to my doctor...
Be the first to leave a comment.I AM SOOOO BUMMED!!!  I just don't understand..When I called my doctor's office a short time later, they still had not received the paperwork... So Im waiting for a call back to see what my next step will be... I suppose I'll need to get a referral for a sleep study test, be sent to a specialist for the constant pain I'm feeling in my legs and feet, also need to be treated for depression and in the meantime, I'm sure I'll go from being a PRE-diebetic to actually having diebetes and then maybe, just maybe they will approve surgery....Soooo Stupid .. !!  Anyhow.... just here to vent... Thanks all....oxox Any suggestions or sample letters of appeal that may have worked for you would be greatly appreciated.... Kel
Don't meet Insurance Criteria
on March 2, 2008 5:52 pm How can that be ?? I don't understand these insurance companies.. Don't they realize that they have our health, our futures in their hands...?? It's like they want you to be on your dealth bed before they will pay for this surgery......When I started down this road with Aetna I asked what are their requirments... I was told I was a perfect canidiate by my Doctor. But that I would need to complete a 6 month supervised diet with my PCP including a consult with a dietician/nutrionist ... In which I did.. |
