Hi all,
1st time poster here, but I've poured over this board for hours upon hours and without even having spoken to any of you or replied in any of your threads, I feel like I know a lot of you.
I'm posting in this thread to let you all know that I spoke with Laurie Todd yesterday - she was in AZ and setup an impromptu talk at a wine bar here in AZ. I was one of two people that showed up so I got a LOT of face time with her - it was awesome! I bought a copy of her book (haven't had time to read through all of it yet) and I'm assuming most of what she told me is in there already, but here are a few of the notes on writing insurance appeals that I took while talking to her (she told me to feel free to share it in my own words with everybody on the msg board):
- Make your appeal look like a professional report (i.e. title page, TOC, cover, etc.). Laurie mentioned that every appeal that she's heard of that was more of an appeal letter than a report has failed.
- Get precedent cases (people that have had their insurance pay in the past for your same operation)
* Get as much info as they'll willingly share with you (name, date(s) of surgery, costs (broken down into hospital, drugs, repeat surgeries, etc.) if possible)
* See this thread for a list of available precedent info: Precedents
- Cite any bad advice you have been given
- Cite peer-reviewed articles concerning the procedure
- Never talk about any of your pain or anguish and never get emotional
* Here, too, Laurie mentioned that anybody she's heard of that ever included this in their appeal was denied - the insurance companies don't care about you or your life, it's all about money
- Send to the right people
* Find the medical director's name, address (sometimes googling or checking your insurer's website works)
* CC attorneys that have won cases against your insurer
- Include cost comparisons showing how paying for your procedure now will save them money in the longrun
Laurie also mentioned that she'd like to see someone on this site be the "keeper of the precedents". While I do plan on starting a thread requesting them, I won't label myself or perform the functions of the "keeper". I suppose this board, in a way (via attachments), could be construed as the "keeper" until someone steps into the role formally. I will also (assuming I write a successful appeal - which Laurie has high confidence in - she's already helped one person get ADR paid for) share my appeal with the community in return for any assistance I get from everybody. Laurie has also promised to send me a version of an appeal that was already written for ADR - with her blessing, I'll post that as well.
I have to say that it was very inspiring to talk to her and I would recommend everyone that has the opportunity to talk to her in person take advantage of it! I had to drive an hour both ways to talk to her, but it would have easily been worth much more of my time than it took. At the risk of sounding like a marketing/PR guy, I'd definitely recommend the book - $15 is pennies compared to what you could save with a winning insurance appeal. If nothing else, buy it to support her in her fight to spread her word so that someday this thread and all the other insurance related threads on this site won't need to exist anymore!
-Anthony