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Insurance Gods....

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reallymary

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I received a letter in the mail yesterday from my insurance company. It said they approved my hospital stay for this surgery because they deemed it a medical necessity. Thanks anonymous Insurance Gods.

 

Nice to know the insurance company thinks I need the surgery.

 

When did the insurance companies start running the medical industry anyway? I mean, if the Insurance Gods did not deem this a medical necessity, then all the work with the physicians, the sleep study, the CPAP lady, the phlebotemist, the surgeon, all of this would have been for naught?

 

I pay insurance...why can't I just get the help I need when I need it? I pay insurance....why can't I be proactive about my health? I pay insurance....why would the insurance company make the physician jump through hoops?? Who is more inclined to have the patient's best interest here? Ummmm....my five bucks is on the doctor.

 

I'm glad that I got the letter...but I gotta tell you, it makes me a bit angry. I do not like insurance companies at all. All of them...life insurance, car insurance, health insurance, homeowners's insurance....all of them! You pay month after month after month....and you pay on time month after month after month. Your fee is not negotiable month after month, it is the same.

 

BUT - when it comes time to PAY OUT - then everything is negotiable and everything is late! They don't have to pay immediately. They can review every detail and they can slow the payout because they are 'reviewing' and 'adjusting.' And they can refuse to pay and they can lowball how much they pay. Oh, I don't think the insurance company gave a damn about me regarding this surgery. They are gambling that it will cost them LESS in the long run, if they let me have it.

 

Sad part is, I know it's true. Good thing is, I know it's true!

 

So...I got my letter. I have made 10 copies, laminated the original, framed one and hung it on the wall, and filed the rest.

 

Nobody gonna deny me now! Lab Band, welcome to my wordl!

 

Mary - letter in hand.

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I received a letter in the mail yesterday from my insurance company. It said they approved my hospital stay for this surgery because they deemed it a medical necessity. Thanks anonymous Insurance Gods.

Nice to know the insurance company thinks I need the surgery.

When did the insurance companies start running the medical industry anyway? I mean, if the Insurance Gods did not deem this a medical necessity, then all the work with the physicians, the sleep study, the CPAP lady, the phlebotemist, the surgeon, all of this would have been for naught?

I pay insurance...why can't I just get the help I need when I need it? I pay insurance....why can't I be proactive about my health? I pay insurance....why would the insurance company make the physician jump through hoops?? Who is more inclined to have the patient's best interest here? Ummmm....my five bucks is on the doctor.

I'm glad that I got the letter...but I gotta tell you, it makes me a bit angry. I do not like insurance companies at all. All of them...life insurance, car insurance, health insurance, homeowners's insurance....all of them! You pay month after month after month....and you pay on time month after month after month. Your fee is not negotiable month after month, it is the same.

BUT - when it comes time to PAY OUT - then everything is negotiable and everything is late! They don't have to pay immediately. They can review every detail and they can slow the payout because they are 'reviewing' and 'adjusting.' And they can refuse to pay and they can lowball how much they pay. Oh, I don't think the insurance company gave a damn about me regarding this surgery. They are gambling that it will cost them LESS in the long run, if they let me have it.

Sad part is, I know it's true. Good thing is, I know it's true!

So...I got my letter. I have made 10 copies, laminated the original, framed one and hung it on the wall, and filed the rest.

Nobody gonna deny me now! Lab Band, welcome to my wordl!

Mary - letter in hand.

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I have a good one for you.. I got my approval letter for the lap band because it was medically necessary, but I got denied the hospital stay because it was not medically necessary... So I guess I am getting my surgery in the parking lot...

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I have a good one for you.. I got my approval letter for the lap band because it was medically necessary, but I got denied the hospital stay because it was not medically necessary... So I guess I am getting my surgery in the parking lot...

lol good one danbar....surgery in the parking lot...i was cracking up when i read that one!!!!!

and the person who started this blog is right about the insurance companies...i was recently approved for the band..but today...i went off on farmers auto insurance b/c i pay addtil for rental reimbursement..and the damn claims adjuster didnt want to pay for a rental up to my max of 900...well i got on the phone..yelled, and put the "a" word in there...(attorney) and he huffed..and said "jus fax me the bill ill take care of it"...i mean come on now..thats why i chose that optional coverage...b/c i knew that if i was to get in an accident i wouldnt have money sittin around for a damn car rental plus scrape up money for a down pmt on a new one....duh!!!!

but with all this being said....u definitely dont hear anything about the insurance companies gettin a bailout from the government....they know how to hold on to their money!!! lol

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Insurance is my favorite thing to rant about. Just bring the subject up and I get a hair across my *ahem.*

DanBar - Did the insurance company give you a rain date??

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you are one of the lucky ones! I am with you. Makes me so mad. They have some nerve. I have high blood pressure, sleep apnea, asthma, high cholesterol pitting edema in my legs and am a borderline diabetic. I am having surgery a week from tomorrow. We are private pay because our insurance company said this lap band was cosmetic. Are they nuts? We pay tons and tons of money for insuance and when we need them, they would rather see us die.

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Hopeful, I'm sorry they deemed this a 'cosmetic' surgery. That is totally ludicrous!! Excuse me for stating the obvious, but I hope that you appealed their decision. Keep fighting, you may get your money back at some point.

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I totally know how you feel. I have one month until I am done with my six month dr supervised diet with a 10% weight loss. It totally sux. Why would they make me have to lose 10% of my body weight before the surgery. I mean isn't that why I am getting the surgery. TO LOSE WEIGHT!!! DUH!!!

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