Denied, again.

[KWT]

How is it possible for some ins company's to find a procedure "medically necessary" and others to not? Seems ridiculous.my RFA request was denied they say it's experimental. Our government says we now have to have ins which I agree with but in return these company's should have to cover treatments. I'm not asking for them to pay for the baking soda lemon peel pineapple cure!

[Teddi]

I am so sorry the insurance company is wasting your time and energy. Who is next on the chain to appeal to? The insurance company again? Maybe the state insurance board. Possibly the local media? When I did it, it sure got action when I elevated it to the state board. It's a stressful f'n hassle, though. Makes me mad we have to beg for what should be given. Get your irate citizen pen and go to work. They count on you giving up.


Teddi

[Bev G]

Hi Kenny,

May I suggest you write to the Insurance Commissioner of your State? Better still call them. Give them a citation for a peer-reviewed paper about the efficacy of the procedure. Call your insurance company and tell them you are filing a complaint with the commissioner. I think that might move things along. Insurance companies don't like complaints to the State.

I hope this might work!

Bev

[KWT]

We are appealing now, we'll see how it goes I have some documents to send along. It's just ridiculous to have to go through this. They will approve chemo at the drop of a hat. Is that not just a shot in the dark? Really?

[Bev G]

Yeah, it's total crap.

[jillbugs4110]

Sorry kenny fight to deny this. I will ask the big man haha....hope you are enjoying the sun. I hate this kind of shit it is wrong I hope they make it right.

[cathy123]

That stinks. Good luck with your appeal.

[janderson]

That's bullshit Kenny. You know I have been down that road before. I think it is criminal. I hate insurance companies and the laws that protect them.

[Coppercent]

Sorry to hear you were denied. We should not have to work so hard for treatment.

Can't believe they did not cover it! My insurance covered my "baking soda lemon peel pineapple cure treatment plan". Sorry! Could not resist that treatment to cure me!

[lauragb]

This infuriates me! You should not have to be dealing with this bullshit. I hope to hear soon that your appeal goes through.

[KWT]

I really read somewhere about the pineapple core treatment and cure. I'm pretty sure it was instigated by the dole corporation as a way to profit from all those pineapple waste products.

[singingholly]

Just hate and can't understand it.
Olivia

[meatie]

The worst of all is that we are just past the 2/15 deadline to change insurance...

[KWT]

The worst of all is that we are just past the 2/15 deadline to change insurance...

I don't think it would matter as it seems to be a state thing. I could be wrong.

[weisssoccermom]

I don't know how many lung mets you have that you want to have zapped but, when I was helping Carolyn with the same 'approval', she ran into a snag when it was more than THREE mets. We were able to find almost the exact same wording in three or four different insurance company's benefit booklets. In addition, it appears that most insurance companies base their decisions on another company (I wish I could remember the name of that place) that has a board of doctors who make these decisions. I wonder if this is the same reason that you are being denied....btw, in Carolyn's case, with more than three lung mets (total...both lungs), it was also considered 'experimental'. I remember that even when she wanted RFA on only one lung that had less than the three mets, it didn't matter. What mattered was the total number of mets. My guess is that the insurance companies don't feel that the 'treatment' itself is experimental but deem it that (again, based on this other company's decision) it is 'experimental' only if there are more than three. Hope that all makes sense. You may also want to dig a little deeper and see if this is the reason why they denied the treatment. As far as it being a 'state' thing.....nope, since Carolyn isn't in Oregon and the other insurance companies are in numerous states....not just one.