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More woes and a question....

piercedqt78

By piercedqt78, in Insurance & Financing

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piercedqt78    658

piercedqt78
Posted

I have once again been...denied. The original submission was denied then, the peer to peer was denied, and now the "fair expidited review" was denied. I was told today that a company called MCMC of Boston would be doing an indepentant review. Anyone ever heard of them? From what I understand this is what they use instead of an independant evaluation. My husbands company pays them to review such cases. ~Mandy

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I'llsucceed    1

I'llsucceed
Posted

sorry to hear of you denial again. I hope your review sheds some better news for you. I too was denied several times & finally as the months past ( 6 months) said I don't wish to wait on someone else anymore & I ended up being a self-pay.

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Alexandra    55

Alexandra
Posted

Mandy, you may have your best chance with an independent reviewer. My fingers are crossed for you! That's how I won my battle with Aetna. Through all of Aetna's internal appeals the people doing the deciding were Aetna employees so the outcome was a foregone conclusion. It wasn't until a third party got involved that I got the right result.

Good luck!!! :)

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piercedqt78    658

piercedqt78
Posted

Alexandra,

You have always had a positive note of encouragement for me and I thank you for that. You are so sweet and kind with your words and suport.

If they will not approve me I am not sure what I am going to do. Selfpay is going to be difficult, we are a single income family and my husband has changed jobs in the last 8 months so getting a loan will be hard. I am sure that this will work itself out as things in life seem to do. My husband and I have never had anything handed to us and we didn't expect this to be any different. I am keeping my head up and staying on my new lifestyle diet (no pop, small bites and eating slower) that way even if I have to wait a while for the band I am still getting healthy. ~Mandy

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piercedqt78    658

piercedqt78
Posted

For everyone that is following my progress I just wanted to let you know that I have been approved!!! My date is July 28th. Thanks for helping me through all of the denials now at the end of the road I get approved, fighting really did pay off. ~Mandy

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HotLikeHer    0

HotLikeHer
Posted

Wooooo HOOOOOO yay!!!!!!!!

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sandie1958    0

sandie1958
Posted

mandy, i have thinking about you . i am so happy . when is your big day i just got approved united health care was really quick for me . who is your carrier. maybe we will have the same surgery date. go mandy goooooooooooooooooo!!!

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