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Old 02-18-2006, 06:06 AM
Judy Judy is offline
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Join Date: Nov 2004
Posts: 194
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Paul my husbands company is also self insured and I was told that they do not over ride what the insurance company says and does. I thought the same that you could contact your company and let them make the decision.
I still had to fight and appeal my rejection just as if they were not self insured (I won by the way after 1 year of fighting) The best advice I can give anyone is document, and docment all your calls both before and after surgery. The main reason I won my case was the fact that this calls are monitored and writen in their computer systems as to who called, why and what the representative said. Fortunately for me the representative failed to tell me if the surgery was out of the country that they would not pay anything, also it was not in the benefit booklet supplied by the carrier. As a result they did change it. My advice is don't give up I truly believe that is what they want and think if they say no enough you will just go away.
Judy
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Surgery Vienna by Dr. Bertagnoli Oct. 16, 2004
ADR L3/4
Fusion L4/5
ADR L5/S1
Diagnosed with Arachnoiditis 11/06
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