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Posted 3/27/2010 12:59 AM (GMT 0)
As many of you know I have been fighting my insurance company for several months in order to be allowed to undergo a trial of a neurostimulator. A few weeks ago I got a letter from them saying that they denied my second level appeal & that I had exhausted their internal appeal process & my only remaining option was to take my case to the state Insurance Commissioner.

Tonight I got a completely unexpected letter in the mail from my insurance company saying that they are going to re-open my case & let redo my second-level appeal in the form of an in-person hearing.

On the suggestion of my insurance agent, we sent the insurance company a letter a week or two ago saying that I had wanted an in-person hearing & the doctor's office screwed up my request & that I'd appreciate it if they'd reconsider their decision. Last week the insurance company told my agent over the phone that my request had been denied, so when I opened the letter from the insurance company today I expected it to say such a thing. Instead I was pleasantly surprised to find just the opposite!

I'm so thrilled! There is no guarantee that they will overturn their original denial of the stimulator, but at least I have a second chance & can present my case in person! I had been really upset because earlier this week I got all the neurosurgeon's letters to the insurance company & they were AWFUL! They said NOTHING except that I was scheduled for such & such procedure on such & such date & that unfortunately the insurance company denied it & that he'd like them to reconsider. It was no wonder the insurance company said no. I was really surprised because I really like the guy & he is a world-class surgeon.

My father & I wrote a really strong letter to the Insurance Commissioner asking him to overturn the decision of the insurance company, but we will now hold off on sending that until after the hearing with the insurance company. He also wrote a letter to my neurosurgeon requesting that he take a look at the letter we wrote & write a new letter.

The hearing is scheduled for Tuesday April 6th. Wish me lots of luck!

Skeye
Posted 3/27/2010 1:12 AM (GMT 0)

Oh SKEYE,

This is great news, everything I can cross is crossed for a most needed APPROVAL!!

(((((((((((((((((((((Skeye)))))))))))))))))))

XXOO
Patti

Posted 3/27/2010 1:17 AM (GMT 0)
OMGosh Skeye, this is fantastic news!!! You will get it my friend!! This will be in your favour. Think positive and i will pray for you!!!!!

Hugs
Posted 3/27/2010 1:18 AM (GMT 0)
 

   Dear Skeye,

 

     This is fantastic news. I hope they are truly going to give your appeal a real chance this time. I know you have had many many heartbeaking let downs. I hope this is the time they truely help you. You are always in our prayers and hearts. Stay strong!!!

 

*hugg*

  dani

Posted 3/27/2010 4:27 AM (GMT 0)
When I saw the title of your post...I was hoping that it was good news re: getting your neurostimulator... You've gone through so much trying to get that darn thing. I know there is no guarantee...but I am really, really glad you get another chance.

I will pray that you get approved this time, Skeye... Hang in there.
Tina
Posted 3/27/2010 4:38 AM (GMT 0)
Hi Skeye:

I, too, will be praying really hard that you get the approval you so richly deserve!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Lorie
Posted 3/27/2010 7:42 AM (GMT 0)
Skeye,
This is wonderful news! At least your request was heard and reconsidered seriously! Maybe your insurance agent said something to them on the phone call, but whatever the reason I'm thrilled for you!

I'm also glad you got the info. your doc sent in so that you can see how deficient it was and have a chance to address that. You know I think this is the case in far more cases than we realize. I know as I've collected my medical records I've generally been disappointed at how much was lacking. I know doctors are busy, but they may not realize just how much that means to us in our struggles for treatment, financial help, etc.

I hope this gets you the trial you so deserve with the SCS!

Cheers to you!

PaLady
Posted 3/27/2010 8:09 AM (GMT 0)
Hey Skeye , Best of luck to you brother may God bless you and help you and your cause , I wish and hope with all i can that you get the decision you need .As someone who also has to wait for others to make decisions about aspects of his life I know how frustrating it can be . Try to remain calm and try (I know its very difficult)to go without expection , but with a positive attitude ,Good Luck my friend !!!!!
Posted 3/27/2010 10:31 AM (GMT 0)
Oh Skeye, I wrote that I wouldn't be posting here anymore for reasons I'd rather not bring up but when I read your good news, I had to write!!! Oh I'm soooooo happy for you my dear girl! You go give them hell! I just know that you will win this time!! Is your Father going to be there to speak also? If so, I'm sure the tag team of Skeye & Pops will come out victorious this time!!!
I'll be prayin for you Little Sister!!!
Big Hugs>Your Buddy,
Pete!
Posted 3/27/2010 12:23 PM (GMT 0)
Congratulations Skye,

I'll keep you in my prayers.
Posted 3/27/2010 3:26 PM (GMT 0)
Keeping fingers and toes crossed. Have been thinking of you. I know it will happen for you!
Keep on fighting
You will succeed
Cata(houla)
Posted 3/27/2010 10:52 PM (GMT 0)
Thanks so much for the support everyone! I really appreciate it!!!

Skeye
Posted 3/27/2010 10:56 PM (GMT 0)
Yea Skeye...I am so happy to hear the good news! I will continue prayers for things to keep going forward to help with your pain..

Sending you a happy hug (( ))
Posted 3/28/2010 5:10 PM (GMT 0)
Good Luck Skeye. I will be praying for you.
Posted 3/29/2010 9:07 PM (GMT 0)
Good Luck to you Skeye, Sure hope you win...
Prayers and lots of soft hugz...
(((((((((((((((((((((((((((((((((Skeye))))))))))))))))))))))))))))))))))))))))))))))))))))))
make sure to keep us posted, okay...
Posted 3/30/2010 12:20 AM (GMT 0)
Skeye, just a quick note to let you know that I'm thinking of you too! It's probably noticeable that I'm still under the weather here, but I am getting better little by little.

SE
Posted 4/1/2010 2:32 AM (GMT 0)
Skeye, This is wonderful news and such a little sliver of hope for the rest of us who are still fighting for attorneys to hear something concerning our cases. Bravo!
Nurse2
Posted 4/7/2010 8:56 PM (GMT 0)
Hi everyone,

I apologize for being scarce the last week or two. I haven't been feeling very well, so it's been hard for me to get online & read.

I had my hearing with the insurance company yesterday. It was pretty intimidating. I sat down at this big conference table across from 6 people (facilitator, medical director for the insurance company, an insurance company nurse, and several people from other departments) & with the exception of the facilitator, who was cvery nice, they all had stone-cold expressions on their face the entire time. We did our best to present my case, but honestly I wasn't super optimistic coming out of it, because I have a very hard time showing other people (especially unfamiliar people) my emotions & I wasn't sure I did a good enough job showing them how much my pain impacts my life. But it must have gone over better than I thought because a couple hours later I got a phone call saying that THEY APPROVED my stimulator trial!!!

I'm absolutely thrilled! It won't be official until I get the letter in the mail, but I've already tentatively scheduled the trial for the end of May, after I graduate. I'm so relieved that this whole mess is finally over! Now I just have to make it until graduation (May 23rd). Thank you all so much for your support! I couldn't have gotten through this without you all!

Skeye
Posted 4/7/2010 9:03 PM (GMT 0)
Skeye,
CONGRATULATIONS!!!! yeah yeah yeah

I'm jumping up and down cheering for you (well in my mind, my body can't do the jump thing!).

It's so great that it will come right after graduation, too. And GRADUATION! I remember last summer when you weren't sure you could get through the school year, and I know it has been a huge challenge for you but you're just about at the finish line!

You are going to make great contributions, I just know it!

I'm thrilled for you, Skeye!

Many many hugs and cheers coming your way! yeah yeah yeah

PaLady
Posted 4/7/2010 9:19 PM (GMT 0)
WooHoo Skeye,
great job...and good luck with your graduation...
Do you have a job lined up???
So glad you got approved by the insurance company, you'll have to coach me..so when I'm up to it I can get my procedure approved...
HUGZ
Way to go...
((((((((((((((((((((((((((((((((((((((Skeye)))))))))))))))))))))))))))))))))))))))))))))))))))))))))))
Posted 4/7/2010 9:25 PM (GMT 0)
YEAH!!!!!! I am so happy for you. It'll be a breeze. You are so deserving.
Catahoula
Posted 4/7/2010 9:56 PM (GMT 0)
Oh Boy Skeye! I just now saw this posting! So disregard the other reply you made on another post. I for one ,and many others here have been following you through this process, and we are so happy that you have been approved! A Very Big Wahoo to you! This is wonderful news. Congratulations to you! Nice Job!

SE
Posted 4/7/2010 10:57 PM (GMT 0)
Skeye...

I was hoping to read this news from you one day :) I'm really happy for you!!

Also, I proud of you for making it to graduation :)

--Tina
Posted 4/7/2010 11:40 PM (GMT 0)
Thank you all for the congratulations! I'm beaming! I just hope that the trial is successful in providing substantial relief. I have a good feeling about it, as do my doctors, so maybe a positive attitude will help! It certainly can't hurt!

Char - I'll be working (at least temporarily) as a vet tech at the same practice at which I currently work. However, the only current opening is part-time, so I'll stick with the part-time position for the summer (and hopefully get to relax some at the same time, and time to study for the GRE's -- ugh) & depending on the availability of a full-time position come this fall, I will either stay where I am or look for a job at a veterinary practice elsewhere. I have some substantial loans to pay off & have to save up for vet school tuition, so I really need to work full time.

Skeye
Posted 4/8/2010 12:03 AM (GMT 0)
Skeye,
I'm so glad you're beaming - you should be! I don't normally have tears brought to my eyes but this good news for you on top of your graduation is really moving to read. Maybe it's the old prof. in me; I wish I could see you walk up on the stage and get your diploma!

GRE's, eh? Wow - you're not stopping! You go girl! I didn't mind the GRE's as much as the Miller Analogies but I don't know if they require those anymore. I'll be hoping that your stim. trial is successful, so you can get some relief as you look forward to vet school. I wonder if any of the new student loan programs, or programs that would allow you to work off your debt would apply in your field. Just a thought.

It'll happen for you. I just know it!

Hugs and Cheers,
PaLady
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