now I appeal

Sunday, January 28, 2018

So the very nice case manager from the surgery place called and told me that the insurance has decided that my surgery isn't medically necessary and has declined. My next step is to appeal. I need to write the appeal, and have the surgeon, and all the doctor's write the appeal and wait some more. And I'm going to send pictures. If the insurance company isn't impressed with the fact that my BMI is a 46, and I have three co-morbidity such as type 2 diabetes, high blood pressure and cardiac issues, if that does make it medically necessary, then I am going to take a picture of me in my underwear. They can see the full glory of 40 years of fad diets,and wrecked metabolism. That should shock em. I will send them a copy of the daily steps I try for, and show that I have been a participant in a medically supervised program, but it does not work. I truly, believe, with every cell in my overly fluffed body believe that this is the route for me. but meanwhile, while the wheels of the bureaucracy that hold the future of my life in it's hands inch forward at a slower than a snails pass, I continue. Today, I worked on Posh. I have put expenses in a spreed sheet for the tax lady, I have done two accounts- have to still do the posh propay card and my paypal account, and I cleaned my posh office. it was probably procrastinating on the tax stuff but it did feel good to have a clean surface. I am a little scared to look at the profit and loss statement of the year. But Posh is very much more than about money. It feeds my soul, it's the good for you part of the campaign that I groove on. The naturally based . best stuff on the planet Because I deserve to to have some nice perks in my life. I absolutely love the stuff. but I know it's fluffy. Posh is not going to solve the worlds problems. My freind Mary, whose had medical issues, some husband is facing medical issues, said she hasn't had any time for posh, anytime for self care, and I thought damm, that's when we need it, when we are depleted, we need the sense of calm and centering. Maybe you don't get that from a face mask and essential oils. Maybe a walk outside is more of your jam. Whatever gets you centered and stable and calm. We all deserve that. I look at my why-and my want- that I wanted a social business about self care. Now fits Posh, and Monat, and my secret idea that's brewing. Now, I have to prepare for the week ahead. I have a big interview on Wednesday, on a position that would solve some of my job woes, so I have to make sure my black slacks and tunics are clean. I got the hair and nails all primped on last Friday. I have a new gym bag to pack for mornings, and thinking about my week- it should be a little bit kinder than the past few. I'm still brewing a new idea in my head, but really need the insurance claim on my stolen posh to come through before I can go forth and burst on it. so tomorrow at work I am going to:
1) finish my insurance claim.
2) contact all my doctors and have them write the appeals for bariatric surgery.

now I have to switch the laundry and the dishes. the dish fairy and the folding fairy are asleep on the job.
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Member Comments About This Blog Post
    good luck w/the appeal.
    656 days ago
    Destroying one's metabolism is a myth. In fact, if you are overweight your metabolism will be higher than normal. Instead of wls, why not cut out all processed foods and fill up on veggies, fruits, nuts, and some whole grains?
    656 days ago
  • CHEROKEE1946
    Have you give this site a real try because there has been so many people on here that was think of surgery but did it one step at a time. Go to ~indygirl and read her story. I think it is amazing. I only say this because I know of at least 10 people that had this surgery and now they have all kinds of blood disorders and even though they lost some weight don't feel the problems are worth that. Plus 4 of them have put some of the weight back on. I wish you luck no matter what you try but I would really research all the pros and cons.
    657 days ago
  • 2DAWN4
    You have several irons in the fire right now. Hope the appeal works for you. I know that usually insurance businesses deny claims that first time so don't give up!
    657 days ago
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