ObesityHelp

Female update..... I did go ahead and have the ablation done due to my heavy bleeding, I hope it all works out & I will not need to have a hysterectomy done.



I am SO THANKFUL for Diana Cox and Dr. Keshishian who attend the teleconference (Wednesday, November 16th) with my secondary insurance on my behlaf.  I am unsure how the hearing over-all went.  But I can say that I was NOT DENIED!!!!! 
But I was not approved either.

On thursday, November 17th, the lawyer from the Trust (The secondary insurance) called and spoke with me personally.  And then followed up with the answer/letter (through e-mail, but will also get mailed to me as well).  Here is a "cut & paste" from that e-mail:


"This email follows our phone conversation of earlier today. Thank you for taking the time to discuss your appeal with me. As we discussed, two things were decided at yesterday's meeting regarding your case.

1. Your appeal is denied. We do not have independent medical evidence that the surgery you request is medically necessary. A more detailed opinion will be sent to you on this w/in 30 days. You should have that by by Friday, Dec. 16.

2. The board is requesting an additional independent medical opinion. We believe our advisors may be too focused on your prior surgery. We want to be sure that their denials are, in fact, based on the language of the plan. The question is not whether your prior surgery needs to be "fixed". We think the question is, instead, more along the lines of whether the surgery is medically necessary based on the evidence we have concerning your present condition.

I will provide you with a copy of the opinion when we receive it. If the opinion is favorable it should change our position on your requested surgery."


So, just GLAD I was not denied!!!!  I have HOPE for an approval!!!!!!