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Orchi update


Guest Mickey

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Guest Mickey

On Tuesday I saw my GT. She told me that a lady from my insurance companies appeals department called her wanting to gather info for my appeal. I got the lady's name and number and called her Wednesday. I left a message and she called me back about an hour later. We talked for about 20 minutes and she told me before we hung up, that she "...has what she needed for a decision" and that I would probably have an answer by the end of next week. I feel like the decision will be in my favor. I really do. I think that I managed to convince her of the legitimacy of my needing this surgery.

Now I just wait a little longer.

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  • Admin

I suspect that its going to be a long week of waiting Carla. I wish you luck.

HUGS

Carolyn Marie

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  • Forum Moderator

Best of luck dear. I'd put an exclamation point at the end of that sentence if i wasn't still a bit sore. Just kidding. I do hope they will approve.

Hugs,

Charlize

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Guest KerryUK

Oh Carla,

I soooooo hate waiting like that. I hope it goes by quickly for you and that the decision made is in your favour. Best of luck Carla.

Kerry

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  • 2 weeks later...
Guest Mickey

Just a bunch of dang liars. Every single dang one of the reps that I have talked with at Cigna Healthspring are liars. "Sure, everything is covered if it's deemed medically necessary." "Denied because it's not covered by Medicare." I am so dadgum mad right now I could spit. And although it is not very lady like, if a single one of the reps that I've dealt with were in front of me now, I would spit right in their faces. Stu[id dang liars. All of them.

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  • Forum Moderator

I'm sorry you are getting such a runaround CarlaMichelle. I'm not certain why a certain procedure is "medically necessary" or who makes that decision for various insurance companies. I have experienced an amazing number of denials of coverage for life saving cardiac procedures that were approved after an appeal. It often seemed that there was a policy of denial to delay payment or to get serious ill people to drop their claims. I'm fortunate to have a wife who worked for years at a hospital getting coverage for patients. She has managed to hit all of the necessary buttons so we are still on the farm. Now that i'm on medicare things seem so much better.

Hopefully it will change for you. I feel your frustration. Unfortunately they never respond to spit as satisfying as it might be.

Hugs,

Charlize

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This is a denial of the appeal from the initial denial. And every single time I talk with somebody at Healthspring I get a different story. Liars is what they are. Just plain dadgum liars. And they are causing me great emotional distress. Period.

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