Sad & Mad

 I have been a voyeur on this site for a while.  I have benefited from others stories and appreciate the journey.  Today I found out that I have been denied bariatric surgery, again.  Last time was 
April '08 due to needing 6 mos of supervised diet.  Apparently they didn't like my PMD's documentation. Instead of appealing, I decided to pursue another 6 months of documentation with my PMD, after all I had waited this long?  Well, I denied again and am now looking for legal assistance.

Would any of you be willing to share your experience with obesitylaw.com?  I live in California. I have BXBS of Illinois and I am planning to have my surgery at The Memorialcare Center for Obesity at Orange Coast Memorial Medical Center.

I would appreciate any feedback or suggestions.

Thanks,  

Cristi A.

The person you need to talk to is DianaCox, shes done a ton of work on this exact issue and guide in the right direction. I am going to send you some stuff she sent me it should help. Also check the insurance forums there is an atty there that can help you, for a fee

 Thanks for the info. How can I get in touch with Diana?  Is she on OH?

I am so sorry that you are going through this.  You may want to check out Monica P. profile.  She went through alot and actually had to get an attorney.  Best of luck to you.

Linda

I used Walter Lindstrom and Obesity Law and they are wonderful. He had WLS so it is a true cause to him. They work their butts off for you. It isnt always easy to get a hold of them, its just the 2 lawyers and a part time secretary, but thats how they keep costs down. I have recommended them to many people on this board and would recommend them to you too.
My biggest suggestion is to not give up and fight for your health!!!

 Thanks for all the feedback and comments.  I have initiated with my husband's HR Department and with an attorney.  I am so ready to be on the loser's bench.

Hello Christi,

My name is Chell and I also have been a voyeur on this site--I like the way you put that :).  Your story is inspirational--I am 5'3, 226 pounds and received my first denial from TRICARE Prime and I was down in the dumps crying about it to my hubby.

I am sorry you have been denied again--thank you for sharing your story because it touched and inspired me.  Keep going girl!   With your determination I know you will get approved --I can feel it from your email!  My profile is listed under "salandmll" as username--lets keep each other encouraged.

sincerely chell

Well it is great you came out of hiding and I do not have anything to add for you, but wanted to welcome you. Also do not give up the fight....it will happen...sometimes not in your time, but in time....don't give up hope!!!

Hi Cristi,

I have BCBSIL and they also denied me twice.  They make it impossible for you to qualify.  Please read my profile, and please DO NOT GIVE UP!!!

My Surgeon had a peer to peer with the Medical director of BCBSIL and they still would not budge and then out of the blue low and behold I got a call!  They sent it out to a Independent for a medical review and They deemed it medically neccesary!

I can send you a copy of my appeal letters if you would like.  PM me with your email addr.

Just do not lose hope!!!  It WILL Happen!!!

Jeni