Im very dissapointed with many people here

[steve55]

Im sorry, but I have become incredibly frustrated in getting anyone to send me proof of their insurance coverage. There are two board members here in particular who have LONG AGO promised to fax or email me their proof , whatever proof they have of the insurance covering their procedures. Some did not have a formal insurance approval letter , but still, I advised them its ok, Ill take whatever they have. Both people seemed gracious and wanting to help, and said they will get it to me shortly. That was about 2 months ago. I followed up and got a reply from one member about 1 month ago saying he would send it. Still, another month pases and no reply to my follow up email and nothing 2 months later. I never got jack from either of these folks. And Harrison knows who they are. Sure, maybe they are busy with jobs etc, but so busy that they cant simply fax or email it? Am I to wait 6 months then? Hell, they probably just forgot about me because ITS NOT IMPORTANT TO THEM!!! Well folks, its VERY important to us who are battling with the evil insurance co's. Please think about others! Dont allow yoruself to forget and blow us off.

Then there's one former board member who as kind enough to come through for me early on, but he is unwilling to let me send it to Richard so that Richard can help others who could benefit from this. This individual asked that I only give out his email on a case by case basis. As much as I appreciate this individual sharing it with me, it also pisses me off that this person is being stingy with sharing their approval that can help others. It completely ASTOUNDS me. ON the other hand, a member here , Gary Morse, was actually excited at the idea that I send his approval letter to Richard so Richard can disperse it throughout the community. This is a man who cant wait to help people, we need more people like him.

But Seriously, help me out here. WTF is anyone worried about by sharing their approvals? Its sheer paranoiya to think crazy things like that insurance is going to ask for the money back just because he/she is sharing their approval. I can understand if this person is still going through appeals, but other than that, I dont get it.

Then one lady I met had a approval she got from another lady, it was a Aetna multi level approval, EXACTLY what I needed! I sent her the one multi level approval I had but she did not reciprocate. She said "I promised this lady I would not share with anyone else without her permission". Well, as it truns out, this original lady is long gone and can no longer be reached, her email is no longer valid. I guess I can understand that she "gave her word", but then it all goes back to what the hell is wrong with people that they are so freakin scared and paranoid to share their approvals. YOU'RE MAKING THE INSURANCE COMPANIES WIN WHEN YOU DO THIS!!!!

Come on people!! We are here to help each other out. Right? Who here has had a ADR approval and not shared it with RIchard yet? SHAME on you if you havent! Richard has asked for these for quite a while now. Ive sent Richard all I have so far, so Ive done my part.

Again, why are we all so cowardice and selfish with sharing our approvals. It pisses me off. Maybe someone can convince me Im overreacting. Please do.Im not one to get upset or blow their top, but the sheer selfishness and lack of compassion to help others is beyond me . And please dont say "My insurance co might ask for the money back" or " Its personal" , PERSONAL MY ***!!!!!!!! Cross out your social security number if necessary. I havent heard one dam case of insurance asking for money back due to sharing approvals ior someone's ID getting stolen because their approval letters were floating around. Give me a break! Its lame *** excuses of paranoid people.

LETS TRY HELPING EACH OTHER OUT FOR A CHANGE, OK????? STOP IT WITH THE FLAKY EXCUSES. That's all Im sayin.

We bitch about insurance co's winning , its because we dont band together to fight them. Its insane!!


Nuff said

[Harrison]

I can’t speak for others, but I can understand what may be happening here. I can only relate this insurance issue to what happened to me during the long and arduous filmmaking process.

Back in 2007, when I first announced the “Getting Back on Their Feet” film project, I was happy that a handful of patients volunteered to be interviewed. After many months of coordinating the interview appointments (in patients’ homes), two people canceled – because of their concerns about insurance coverage. As well, one of patients had surgery and was already reimbursed for the ADR procedure! She was concerned that the insurance company could potentially come after them and shake them down for the cash…

I finished all the filming last year. And most of the editing as well. Thereafter, one of the interviewees decided not to be part of the film, and was insistent on being removed from the film entirely. Why? I am not sure. Could it have been because of insurance reasons? Maybe. I’ll never know. But it sure set me back many months...and many dollars that I didn't have.

I asked, and still ask, that people send me their documentation of winning appeals/reimbursements so good people like you don’t have to deal with the run around. As well, I have a confidentiality process in place to ensure people’s personal information is protected.

Folks, if you have any documentation, please email or PM me and we can talk. I want to help all of you!

[jchebert1979]

There really is no excuse for this. All personal information can be blacked out so that each letter is totally anonymous. Sharing approval letters has got to be one of the easiest ways to help others on this board.

[Dave C]

Im sorry, but I have become incredibly frustrated in getting anyone to send me proof of their insurance coverage. There are two board members here in particular who have LONG AGO promised to fax or email me their proof , whatever proof they have of the insurance covering their procedures. Some did not have a formal insurance approval letter , but still, I advised them its ok, Ill take whatever they have. Both people seemed gracious and wanting to help, and said they will get it to me shortly. That was about 2 months ago. I followed up and got a reply from one member about 1 month ago saying he would send it. Still, another month pases and no reply to my follow up email and nothing 2 months later. I never got jack from either of these folks. And Harrison knows who they are. Sure, maybe they are busy with jobs etc, but so busy that they cant simply fax or email it? Am I to wait 6 months then? Hell, they probably just forgot about me because ITS NOT IMPORTANT TO THEM!!! Well folks, its VERY important to us who are battling with the evil insurance co's. Please think about others! Dont allow yoruself to forget and blow us off.




Steve

I fully understand your position. I am one of the two you are talking about. I was informed by my company, (we are self insured) that if I broadcast in any way, shape or form that my ADR's were covered, I "WOULD" lose my job. When it comes to priorities, my family comes before anything else. Sorry if this pisses you off, but in this frigged up economy, I cannot take even the slightest chance in having this happen.

I know you will not give two ****s either way, but I'm truly sorry for not informing you of this.

[Harrison]

Dave, thx for posting. But I am so angry -- but not surprised -- to hear about the outcome with the insurance company's demands placed on you.

You may not helped specifically with a successful appeal letter, but you helped educate us about the evil tactics employed by "insurance" companies.

:mad:

[Jdouglas]

For what it's worth, I have the studies that United uses to justify their position that artificial discs are not proven long term. It is the opposite of what is being asked for, but still a window into the method behind the madness. Unfortunately, the word document is 133k and as such I cannot upload it. Harrison, how can I get this on the site for everyone's reference?

[Harrison]

J, you should be able to post it yourself If not, email me to:

- send me the doc, I'll post it;
- figure out why you cannot attach it.

Thanks!

[Jdouglas]

I sure wish I had a approval notice to post. Alas, here is the rejection statement of policy with references to studies...

[steve55]

Steve

I fully understand your position. I am one of the two you are talking about. I was informed by my company, (we are self insured) that if I broadcast in any way, shape or form that my ADR's were covered, I "WOULD" lose my job. When it comes to priorities, my family comes before anything else. Sorry if this pisses you off, but in this frigged up economy, I cannot take even the slightest chance in having this happen.

I know you will not give two ****s either way, but I'm truly sorry for not informing you of this.


Then that's 100% understandable. Apology accepted. Im sure you can understand as to why I was feeling blown off. I just thought you were too busy with life and just forgot about me. The last PM I got was that you were working on it. I followed up a 2nd time with you with no reply. Ok, Cool.

On a seperate note, as you mentioned , your Insurance is different than 99% of people's here. I think your employer actually paid, not a 3rd party insurer like aetna or Humana etc. I find it weird that your employer even thought of the possibility of you posting it on the net. You must have brought it up by asking first? I guess the idea is that if other employees see your approval online, then the employer would also have to pay for them too if they need ADR. Im no law expert but If they fired you for that reason, Id think they'd be 100% vulnerable to a mega lawsuit. Man, if I was in that situation, Id sure love to have my I phone "recorder mode" turned on when I went in to ask about it, and record them saying that to me. Id be sure to address the person /mgr by name so the recorder got it loud and clear as to whom was telling me this. Lawsuit city!! Im not a fan of people filing frivilous lawsuits for profit, but when employers fail to provide proper coverage that the employee PAYS good money for, and then they threaten the employee, then they deserve one!! You could then have a early retirement to boot. But I understand you dont want to even deal with all that mess and I dont blame you. Someone with more profit motive may have been drueling at the chance. Im no attorney, but that reaks of "illegal" to me all the way.

Well, thanks for finally letting me know here at least : )

[Fuzzy]

I know of a few people getting fired for blogging internal company information. If the company paid it would be internal information. I am not sure this could be used for a lawsuit. Better oblige if you care about your job.

[Jack]

I know of a few people getting fired for blogging internal company information. If the company paid it would be internal information. I am not sure this could be used for a lawsuit. Better oblige if you care about your job.

Yes, I agree. Some states, like the one I live in, do not need to give you a reason to terminate your employ. Unless you have a contract with your employer.

[steve55]

Once again, a board member who promises to send a copy of his approval letter has chickened out and dissapeared. I wont go so far as to say who it was but at least this person verbally gave me the info so I guess he wanted to help as much as he could without actually giving a copy of the approval letter. Ill give em that. BUt a verbal documentation is no where as strong as having the approval letter. He never told me why but I know why because after telling me he would get me the letter, he said "can they rataliate and ask for their money back? ". Man, its been 3 years since he won his appeal. Come on man, 3 f'n years!! AInt no way in hell that would happen, its paranoiya at its extreme. ALso, it never has happened as per all the back boards I have been on for years now, ...(correct me in Im wrong Harrison, you would know idf anyone knows). No way it is legal, no way in hell it would stand up in court. Approval letters admit they pay due to medical necessity and covered benefit (besides, too obvious it would be based on rataliation if they did ask for money back and would never be held up in court by a judge which is what is needed to collect, and as far as credit goes, the credit bureaus would laugh in their face if they filed a collection once the approval letter is submitted to them) Its no different than a car dealer saying "Oh, I made a mistake when I sold you that car at $10,000, I want to file a motion or file on your credit report to get my money back" . They cant renig after the fact!! And most important, he never signed anything (as no one ever does) that they cant share that information with anyone.

Now, I know Dave C case was different cause his was employee sponsored and he says his emoployer specifically threatned to fire him over it (darn, where is that hidden I phone recorder when you need it, .... that would be a major law suit followed by early retirement if they actually did that!!) However, as in Dave C case, this person hasnt returned my calls, hasnt repsonded to my messages, just ignored me like I dont exist anymore. Nice.

I dont know, Im so sick of people only caring for themselves, I almost dont even want to help anyone else when Im done with mine. That may sound childish, I know, but dam it, when you see everyone not willing to help you, people chickening out cause they only care about numero uno, and you yourself work your as off to put together your own appeals case, it does make you ask yourself "if so many people are only out to cover their own ***, why should I help people when no one helped me"?

Look, if there was even ONE SHRED of evidence or case out there where a insurance company ever came back and asked for the money back based on retaliation, i'd change my tune in a heart beat and would totally not even ask for it as I wouldnt want them to put themself at such great risk. BUt in the , what, 7 year history of people sharing approval letters, there is not one documented , or even reported case where an insurance co asked for money back based on retaliation for sharing an approval letter. It hasnt happened.!!!! Get with it people, it DOESNT HAPPEN!!

Not being able to get this 2nd approval letter could make or break $42,000 because it would mean that Aetna can say "oh we made a mistake on that one case you are talking about".

Im so dissapointed I cant even think straight.Im down right pisssed!!The number of people I have encountered who can help but choose not to out of what I see as completely unfounded fear is unbelievable. Ya know, it will be just as easy for me to turn down sharing my approval letter if I win my case by saying the same lame *** excuse. And I might just do that.

So Harrison, are you having any luck with getting approva lletters? I wont be one dam but surprised if you are not getting any besides the 2 I shared with you so far. People only watch out for themselves and say " screw the next guy, Im watching out for my own ***" . So noble. That's the way this seems to be working. Im sick of it, Ive said my peace, Ive vented, and I wont feel one dam bit guilty if I decide to be less than resposive to people's requests for my help. NOt one bit guilty!!! Im hardened after this experience. After seeing how selfish people are, Im done with it. Ive finsihed my appeal, I worked my *** off for the few approval letters I managed to get.

Im sure alot of people will come on here and act all surprised about my experience and claim they would share their letter if they had one, but ya know, based on my expeience with people, I seriously doubt it. Its all talk, easier said than done. When it comes crunch time, people are chicken **** and care only about their own skin.

[Harrison]

A few people have reported this post to complain (something that rarely happens). I'll leave it open for the moment, but will consider closing it later (when/if I have more time).