Diana's helpful eye

Our resident insurance/legal expert very kindly had me over to her house and cast her peepers over my appeal, now that I'm lawyer-free and facing the state's Department of Managed Health Care on my own. Diana had helpful suggestions to make, I felt reassurred about the appeal's basic strengths (regardless of the eventual outcome), and I got to see her newly renovated bathrooms done by her husband, who's clearly a genius. YAY!!! Thanks, Diana! I owe you lunch -- soon! Alison * * * * Quest for DS officially began 2/28/05 Currently appealing insurance denials to CA's Dept. of Managed Health Care * * * * "Waiting is not mere empty hoping. It has the inner certainty of reaching the goal." (I Ching)

Bah, her appeal package was already exquisitely presented and prepared, and my comments were mostly to tailor it just a bit more to her specific cir****tances, and to add a couple of references that were particularly helpful to her arguments. Alison, you finalize and file that appeal and then go on with your business for the next few weeks, and let the DMHC do their job. Before you know it, you will be making your plans for what to do with your winter break. I'd take pictures of my new bathrooms, if only to show off the most important rooms in a DSer's house, but there's no way to get an angle that shows off their "charms" properly. Mostly, though, I'm glad the refuse from the last year's remodeling jobs has finally been removed -- for now. And steeling myself for the next set of projects my husband has plans to start ... more months of disarray, sheetrock dust, painting mess -- but at least he's contributing (non-taxably) to our home's value. And at least I don't have to be home while most of it is going on -- I already know lots of cuss words, and don't need to learn any new ones!

Does he contract himself out to do work? My hubby has been "getting around to" numerous jobs around the house for 4 years now (since we moved in). He has the materials (clogging the garage) he just hasn't gotten around to it. My sister bought him a circle that said "tuit" and when asked, she said "I heard you needed to get a round tuit." He was not amused...

Sadly, without prodding, finishing a project is not his forte' either. I have to schedule parties at the house in order to get him to finish anything, and even then, it's not always REALLY finished. This particular project caused him to unearth the crown molding for the walk-in shower in my bathroom that he otherwise "finished" over three years ago, and he FINALLY put it up (of course he didn't caulk or paint it yet, but at least it looks more finished than it did with the gap between the tile wall and the ceiling!). And he was supposed to finish repairing a wall and replace a single pane glass window with no screen in his daughter's bedrooom while she was visiting her mother in VA for three weeks (7/29 - 8/22), and then repaint the room -- but the bathroom project took over TWICE as long as he had anticipated, and he never got to her room. Sigh ... I need one of those round "tuits" too. He ended up cutting the completion of the bathroom project so close to the party that we had to hire cleaning people to come clean the house after he FINALLY got the last of the crap he had accumulated in the courtyard and driveway thrown out/cleaned up, and there wasn't time to clean the rest of the house -- which was filthy with sawdust, drywall dust, painting mess, and enough cat hair to build two new cats (what was the point of trying to clean thoroughly while he was still working in the house??). I am so happy to have a clean house now that I am leary of his starting his next set of projects. "The shoemaker's children have no shoes" and the former contractor's family lives in never-ending and never completed projects.

Okay, the bathrooms are a dream: beautifully designed AND with lovely trim, detail, etc. The bathroom off the master bedroom is particularly fab (can you tell I live in a 1970s tract house with unremodeled bathrooms???), with a wonderful, well-lit, slate-tiled shower (no need for door or curtain as it's its own little room complete with bench, recessed shelves for toiletries, and so on). Worth of a design magazine or a showcase at Expo, I assure you. I've never had lovely bathrooms, despite other positive points of houses I've lived in, so I was salivating. Uh, Diana, if you and your husband wake up one morrning to find a larger lady singing in that shower, go back to sleep and let me finish my ablutions in peace! Alison * * * * Quest for DS officially began 2/28/05 Currently appealing insurance denials to CA's Dept. of Managed Health Care * * * * "Waiting is not mere empty hoping. It has the inner certainty of reaching the goal." (I Ching)

Such a' bathroom,complete witha DS'r to add aroma! ;haha

Alison, When will you be submitting your paperwork? I'm crossing my fingers and toes for you.........Good Luck! Kathy

Aw, thanks, Kathy! I'll be FedExing the appeal on Tuesday or Wednesday, depending on when Kinko's can do some binding for me after I incorporate changes to the appeal tomorrow morning. I can use all the positive thoughts I can get, so I really appreciate your post. Alison * * * * Quest for DS officially began 2/28/05 Currently appealing insurance denials to CA's Dept. of Managed Health Care * * * * "Waiting is not mere empty hoping. It has the inner certainty of reaching the goal." (I Ching)

Hi Alison, YES, you are VERY lucky to have Diana's help right there in your neck of the woods! She has helped me tremendously in the infinite times I have had to come up with this or that being frought over wording or choosing text, etc. She has ALWAYS been there for me and without her insight and passion for the cause, I would have felt defeated LONG ago . I am still in the game - possibly my last though as Larry Slade sent the massive package to our company for an IMR. I remain hopeful at this point. Diana, I'm hoping to have you up here in B'ham to celebrate MY victory to come and will make this my first taste of wine in a LONG time that I'd love sharing with you. Good luck Alison - we're all pulling for you! Hugs, Kris

Ah, fighting the insurance companies is a labor of love for me, as is working with you wonderful women. I have truly gotten more than I've given in doing this, in getting to know you, and you all have done the yeoman's part of the work -- I just put a little spit-shine on it. And you have to know that we lawyers are always full of spit ... So, Kris, when do you leave for Nigeria? I'm not sure you've shared your latest assignment and adventures-to-come with this board!!