Finally received approval after a year of denials. Hired Walter Lindstrom and, with Dr. Patterson's help we were successful in getting ODS to overturn their denial. Surgery scheduled for April 19, 2004 I'm 41, 348#, 5'7".
Cats - Bailey, Riley, Lucie, Gracie
Dogs - Sam-I-Am the best puppy in the whole wide world
Housework - they're kidding right??? Does anyone list housework as a hobby???!
Auto Racing - I would if I could but unfortunately there are speed limits...
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Surgeon: Emma Patterson, M.D.
Nike is self insured and uses ODS as their claims administrator. They have a fiduciary responsibility to protect Nike's financial interests, i.e. save them money. I wouldn't say they were "bad" to deal with, but I only had two appeal chances. After the first denial I didn't want to waste any chances, so I hired Walt Lindstrom to handle my last appeal. I had my appeals hearing with ODS last week and Walt and Dr. Patterson were both present via telephone. We all talked to the ODS committee. An hour later Walt called me and told me ODS had overturned their previous denial and approved me for the surgery. I would consider hiring someone to help present your case if you do not have very strong co-morbid conditions such as diabetes.