Lisey

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Those insurance people are jerking me around, despite the lady I regularly speak to being quite nice.  They told me that due to the ERISA of 1974, that this act affected my employer-driven policy such that I only get one appeal as opposed to two appeals that everyone else gets.  Research shows it is the superior operation in terms of %EWLS, amelioration of 3 of 5 major comorbidites, & less complications.  They're either basing it on upfront $$ considerations, or are idiots . . . okay, maybe that's too strong of a word.  They're either concerned about $$ or are really lax in their up-to-date research staff.  I really resent the trouble this is causing me.  I'm trying to write my dissertation proposal - like that's not enough research & writing without having to basically do another completely different comprehensive research/literature review & summary. 

12/5/08
Insurance denied my surgeon's request for a sleeve gastrectomy citing my BMI as not being high enough.   Dr. Fabian had told me that he was planning on submitting it as a sleeve gastrectomy with duodenal switch, the ins company didn't even say anything about the DS.  I'm going to write them an appeal letter & also send it to my dr & ask him to change it as he sees fit & to also submit it, not that I think it will help now, but it might later since I expect to get denied again.  Hopefully, I'm just being overly pessimistic & they'll approve me b/c I wrote such a great appeal letter (tongue in cheek!)