I'd been warned about hiring a lawyer ...

by some other posters, which is why I took such care compiling my own rebuttal to Health Net's denial of my appeal for the DS: ultimately I trusted no one else to get it right and I was SO right to think so. Here's my email to Gary Viscio: Gary - I received a copy of your letter to California's Department of Managed Health Care today, and I'm disturbed to see some significant inaccuracies: 1) contrary to the second paragraph of your letter, I have not yet been approved for bariatric surgery; 2) Health Net's denial of my appeal for gastric reduction with duodenal switch was NOT based on the grounds that this surgery was experimental! Clearly your office has used a form letter that was *not* tailored to my specific case. My own letter to California's Department of Managed Health Care, which I included in my packet to you, states the reasons for denial, my history with Health Net, and my rebuttals very clearly, and I would have expected your office to study these materials more carefully. I'm distressed to see these inaccuracies, particularly with regard to the basis for denial -- it's totally inaccurate and may impact the outcome of the DMHC's decision. Further, I want to make sure that you forwarded my letter and documentation to the DMHC in your appeal to them. Please contact me as soon as possible regarding this matter at 415-902-6972. Regards, Alison M____ Suffice to say that I'm REALLY pissed off and I'm not sure how to proceed with him now. Suggestions? Any use in having him call me and requesting him to rewrite his letter and submit it for my approval first? The inaccurate one has already gone in the mail. I'm so @#$%^&*()_+ sick of incompetence I can't tell you. Alison

Did I mention that I'm PISSED OFF???????????????? I just now called Gary on his cell phone and left a succinct, direct, but still curteous message telling him there were serious inaccuracies in the work that his office did on my behalf and in the letter that he put his name to, and I needed a call back on this ASAP. I can't tell if this is actually his appeal letter to CA's DMHC (it's addressed to them) or notification that he's acting on my behalf. I think it's an all-in-one letter, actually. Well, I'd rant on but there's no point -- you get the drift. Alison

thanks for posting, I dont need another inacurate form letter either, thats what dr d office did, so now Aetna is sending me to dr Roslin for a 2nd opinion, Ill follow your case with Gary before proceeding, My union coordinator doesnot feel he is required .

At this point I trust nothing and no one except myself. I'm going to get Gary/his office to tell me what they forwarded, and if they didn't forward my own response to my denial *as it was,* I'm FedExing it directly to California's DMHC with a cover letter. Gnashing my teeth here ...

Someday your story will make a great Movie Of The Week......I know that has to be frustrating. People in my life have been braindead as well, so while my trials are different than yours, I can relate to how stressful it is to find out other people can't do something simple correctly.

Alison, I am so sorry this has happened to you. I do know that the first thing Gary sends out is a letter letting them know he will be acting on your behalf. After that, Health Net may then make you sign a release allowing him to be part of your medical information, etc. I am sooo sorry....I am sure once you hear from him all will be better. He seems be able to get these cases overturned more than anyone else. I am sorry. kelly

Yeah, I couldn't figure out if this was just a letter of notification to the DMHC, letting them know he's acting on my behalf (the letter does state that) or the actual appeal letter (because he addresses my case, though not accurately). Hopefully we can iron out the problem -- but if this isn't the actual *appeal,* I'm going to want to review that for accuracy before it goes out. I shouldn't have to do that, but if it's still in process I'm going to have to. One way or another, a chat with Gary is in order SOON. I would have chosen him anyway, no matter what feedback people gave me [and most of it was positive], but to everyone out there, NEVER TAKE YOUR HAND OFF THE STEERING WHEEL!!!! No one cares as much about the outcome of your case as you do. Alison

Oh Alison, What a bummer! Hopefully you can get this all straightened out. I can see how this would make your blood boil. Hang in there, and get the answers to your question, sure hope this works out. {{{{ HUGS }}} Brenda S

What a disappointment. There's simply no excuse for that. I'm finding that more and more often in my daily exchanges with people--at any level--I have to S-P-E-L-L T-H-I-N-G-S O-U-T in V-E-R-Y S-I-M-P-L-E sentences, almost as though I were talking or writing to a first grader. Then I have to check to make sure they understood the issue/what I was telling them/etc., then double check. Granted, I have a tendency to deliver too much info at one time, so I guess it's good practice for me. But geez, even with the Communications 101 approach, it's amazing how often they STILL get it wrong. I'm sorry for your frustration; I'm sure it's the last thing you need right now. I would say this blunder earns you immediate and unquestioned pre-approval status for any letters or other material sent out on your case.

Well, so far, it just never ends, does it. I would expect more from an attorney paid to take the case. Stand your ground, Alison. This is ridiculous, as usual. with you every step of the way, Starr