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And then they said NO: Sept 6 2006

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Lap_dancer

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and then they said NO

[06 Sep 2006|04:23pm]

 

 

 

 

 

Everything I have done in my life has led me up to this moment. My reading of positive books, my most preferred books by Gerry Spence "How to Argue and Win Everytime", there was a Gerry in my orientation group ( a sign?) there was an orientation class happening on a Monday that I happened to have off ( a sign?) that Monday was only a few days from when I first called this center ( a sign?), my ability to deal with insurance companies after being responsible for that when the business had insurance ( past ability that come to my aid now?) being a secretary for seven years and writing business letters ( so I can deal with corporations?) and appealing a "Not covered".

 

When I spoke to my insurance company did I expect them to tell me it wasn't covered? Of course! Who am I kidding? I need this so bad so of course it isn't covered! Does NO ever mean NOOOO? Hell NO. Not in my world. This is where stubborn comes in handy. This is where putting on the b8tch hat of determination makes for a more positive result. Knowing that this person is a human being, knowing that she is doing her job and she didn't write the rules and knowing the last thing she wants to tell a 355 pound woman is "NO" your insurance doesn't cover this procedure that will likely lengthen your life; Knowing that gives me a calm when I speak to her. Her name is Darlene and she is the next level after customer service. There are always the other levels of people that you speak to. They work at banks and they reverse bounced check fees, they are supervisors that reverse policy under special circumstances, I was shooting for the special circumstance and I believed with all my heart that when I spoke to her yesterday, I WAS the special circumstance.

 

I did something with Darlene that I have not done since I got this heavy, I cried. The human in me escaped and I wept. I apologized. She told me it was okay, to "let it out" and I did. I told her that I had never cried about this before but that I felt like "No" was a death sentence. "He told me ten years" and then I cried some more. She told me she too had dealt with something similar, not weight loss surgery but an illness. *there are real people on the other end and they know* I think everyone has a loved one in their family, extended family or friend who is obese. They love them and they worry. They see the stories on television and in the magazines "Woman loses 200 pounds" or worse still ( 1 ton man stuck in door frame) How did they get that way? I know I know!!

One pound at a time, one mouthful at a time.

 

So they said No and I cried. Then there is the BUT. The but is called "medically necessary". ((and I'm here to tell you that medically necessary is me)) The steps to follow are that my doctor (the one who recommended gastric surgery, the one who knows I have tried, the one who has been on this journey with me) needs to contact my insurance company and follow the procedure outling why I need this. (10 years?) So I compiled a letter and I sent it by fax to him. I'll eventually post them on here.

 

Waiting now. No? Yes? If it is no, I swear to all that I will drive to an appeals hearing and I am completely prepared to strip naked in front of all of them. I will lift my stomach and offer that they can hold it if they want to "you can even touch it, here..it's okay!". How many think they would coil with repulsion? I do. They don't know how determined I am.

 

Waiting.

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and then they said NO

[06 Sep 2006|04:23pm]

Everything I have done in my life has led me up to this moment. My reading of positive books, my most preferred books by Gerry Spence "How to Argue and Win Everytime", there was a Gerry in my orientation group ( a sign?) there was an orientation class happening on a Monday that I happened to have off ( a sign?) that Monday was only a few days from when I first called this center ( a sign?), my ability to deal with insurance companies after being responsible for that when the business had insurance ( past ability that come to my aid now?) being a secretary for seven years and writing business letters ( so I can deal with corporations?) and appealing a "Not covered".

When I spoke to my insurance company did I expect them to tell me it wasn't covered? Of course! Who am I kidding? I need this so bad so of course it isn't covered! Does NO ever mean NOOOO? Hell NO. Not in my world. This is where stubborn comes in handy. This is where putting on the b8tch hat of determination makes for a more positive result. Knowing that this person is a human being, knowing that she is doing her job and she didn't write the rules and knowing the last thing she wants to tell a 355 pound woman is "NO" your insurance doesn't cover this procedure that will likely lengthen your life; Knowing that gives me a calm when I speak to her. Her name is Darlene and she is the next level after customer service. There are always the other levels of people that you speak to. They work at banks and they reverse bounced check fees, they are supervisors that reverse policy under special circumstances, I was shooting for the special circumstance and I believed with all my heart that when I spoke to her yesterday, I WAS the special circumstance.

I did something with Darlene that I have not done since I got this heavy, I cried. The human in me escaped and I wept. I apologized. She told me it was okay, to "let it out" and I did. I told her that I had never cried about this before but that I felt like "No" was a death sentence. "He told me ten years" and then I cried some more. She told me she too had dealt with something similar, not weight loss surgery but an illness. *there are real people on the other end and they know* I think everyone has a loved one in their family, extended family or friend who is obese. They love them and they worry. They see the stories on television and in the magazines "Woman loses 200 pounds" or worse still ( 1 ton man stuck in door frame) How did they get that way? I know I know!!

One pound at a time, one mouthful at a time.

So they said No and I cried. Then there is the BUT. The but is called "medically necessary". ((and I'm here to tell you that medically necessary is me)) The steps to follow are that my doctor (the one who recommended gastric surgery, the one who knows I have tried, the one who has been on this journey with me) needs to contact my insurance company and follow the procedure outling why I need this. (10 years?) So I compiled a letter and I sent it by fax to him. I'll eventually post them on here.

Waiting now. No? Yes? If it is no, I swear to all that I will drive to an appeals hearing and I am completely prepared to strip naked in front of all of them. I will lift my stomach and offer that they can hold it if they want to "you can even touch it, here..it's okay!". How many think they would coil with repulsion? I do. They don't know how determined I am.

Waiting.

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