United Brachial Plexus Network, Inc.

I need to vent here! I am scheduled for a nerve transfer on the 26th of September with Dr. Nath. Everything is ready, surgery s cheduled, airline tickets, hotel, rental car, everything except the INSURANCE! I have BC/BS primary and State Farm Auto is secondary. NO ONE is willing to pay for the surgery(out of network). The reason that we scheduled it soo soon is that if there is a chance for bicep recovery, it has to be done right away( we all know the basic 2 year rule for muscles, I am at 2.5 years but Dr. Nath thinks there is still something there). My mom called our state senator yesterday and he is working on it for us now! We just don't have time before surgery to appeal with anyone, I have a flight out in two days! GRRRRRRRRRRRR I get so mad dealing with this! The senator said to pack my bags but I don't want to get my own hopes up either! If I can't get to Texas for this surgery, I can always have the Gracilis Transfer, but that is much more costly, and more time envolved, and longer recovery time as well. With being a full time student, its hard to get any surgery in anyways and I have to be a full time student to stay on my fathers insurance! Why don't insurance companies have a heart!? Thanks for listening, I just needed to vent!
Courtney

Hi Courtney,

I want to wish you luck with the insurance situation and the surgery. Calling your state senator is a good idea. I was in contact with (I believe it was - this was about 3 years ago) our state's Office of the Chief State's Attorney who got involved a little bit on our behalf just by having me send insurance company a form from them saying that they wanted to be notified of insurance company's decision. I think it made insurance company a little bit nervous because they approved out of network without any appeals and also asked me why I had Office of the Chief State's Attorney involved. Whatever happens with insurance, is the cost of surgery something that you can handle paying for even if you borrow for it?

Again, Good Luck from The Andersons!

Nancy! Great to see you posting here! I bet you can understand a bit what I Am going through. As far as the cost of the surgery, almost $44,000! My dad is in the process of trying to see whta he can do. My mom has the $10,000 like I stated in another post, but if I go with no insurance, they want it all up front! OUCH! I dont think my parents even have any friends with that kind of $$ just laying around! Its all a pain in the A@*!!! Anymore ideas??? Thanks!
Courtney

What difference is it WHERE you have your surgery???
They are not paying for your flights or hotel or food? So difference does it make??? YOu are going to a damn great specialist and you don't have one locally! Aren't you entitled to getting the best person for your issue?

YOU FIGHT LIKE THE DICKENS AND GET EVERYONE ON THE HORN - CALL THE GOVERNOR'S OFFICE - CALL EVERYONE YOU CAN THINK OF - THIS IS WAR!!!

you go girl!!
-francine

Thanks Francine! I appreciate all the support! My parents are on top of everyhthing! My dad talked with Brenda today and as long as we have %10,000 when we go on Thursday, we are all set for the time being! I was glad to hear this! At least now we have a bit more time to fight with people! They ar e crazy fools if they think that I am not going to fight them all the way when there is a chance at getting some functional use of my arm back! I want to show up at my insurance mans house ans show him that there a re amany things that I cant do wi theis stupis arm of mine! Then maybe he wouls understand!!! I hate dealing with morons!!!! I Am sure that you all understand! Thanks guys!
Courtney

$10,000 I mean sorry.....

You shouldn't have to do this...it's total madness....I will never understand how these insurance companies ever got such control over people's lives. It's when I read tings like this that I am so grateful that we have the NHS. It might be a lumbering dinosaur with all the moneuvrability of a Sinsbury's shopping trolley, but I for one am bluddy glad its there.

Will be thinking of you on the 25th Courtney...good luck...

Liz xx

Thanks Liz! Ther eare rotten silly b@s*ar@s! I will get through this and report back soon!
Courtney

My flight leaves Detroit tomorrow morning at 7 so I Am going!!! YEAH!!! I will report when I get back! Thanks to everyone for the support and advice!
COurtney

Courtney,

I have a correction to my above post. It was the Office of the Attorney General, State of Conn. who helped us out. The form was entitled "Medical/Insurance Records Release and Consent Statement". It basically grants permission to my insurance company to release records pertaining to Eric, including but not limited to, medical, billing, and insurance records, to the Office of the Attorney General of the State of CT, and to otherwise discuss with such Office Eric's case as necessary to resolve any outstanding claim for coverage and/or pre-certification of coverage for any medical service rendered for the benefit of Eric.

Once they got this they didn't mess around. Out-of-network surgery was approved without any appeals. Less than 2 weeks later we were in New Orleans.

Good Luck again!