Thursday, September 6, 2007

Looking for an open door ~ finding a window

This afternoon when I was going through the daily stack of mail my eyes focused on a letter from the insurance company. They told me that they had 3 weeks to make a decision on my appeal ~ I was thinking it wasn't a good sign that they had already made a decision. DENIED ~ again ~ did I really believe that they were going to make this easy for me? Basically, they said that there was a local doc who said he would do the decompression for me (I think his exact words were that decompressions are a routine procedure) and that was their final decision. If I didn't like their decision I was instructed to submit another appeal.

First of all ~ did they even READ the two excellent letters of recommendation that I submitted from two outstanding local doctors? Probably not ~ I envision they took one look at them and then tossed them into a file. SERIOUSLY ~ I have been paying premiums to the same insurance company for almost 8 years now and they spend two seconds in deciding my future!?! BTW ~ the doc they have selected to do my surgery was my fourth surgeon who I dubbed 'the godfather' ~ nope ~ still won't let him cut my head open ~ his bedside manner was absolutely horrible!

SO ~ maybe all this time I was looking for an open door when I really should have been searching for the all too discreet window located above the door ~ of course ~ why didn't I think of that!?! I went for an hour run/walk tonight to help me digest the denial letter and to figure out what my next game plan will be. A name came floating through my mind ~ a name I had seen in some of the Chiari Yahoo group chats ~ a surgeon about 20 miles north of here ~ studied under Dr. Milhorat (TCI) ~ great success with surgeries ~ treats chiari and the secondary problems, too ~ compassionate ~ caring ~ empathetic ~ possibly in-network ~ My mind was racing faster than my legs could carry me back to my car. Could this person really be for real or did my CSF starved brain make it up? Has he been there all along ~ right under the radar???

Sure enough ~ my recollection was right ~ he is local ~ and ~ wait for it ~ he is in-network with my insurance company. So ~ first objective, tomorrow morning, get a referral for this new surgeon ~ maybe he could do my surgeries? I am hanging onto hope here ~ trusting that the window will show me the way to the light.


Queli said...


BillyBob said...

That is just AMAZING. (p.s. I don't know what to do at this point, they wont give me supplemental oxygen. I'm at an impasse.)

Linda said...

Lace they are not trying to make this easy at all are they? I love how people who have never even seen us in person can make such calls like this that effect our lives and they do it in the blink of an eye and without a second thought. Hang in there gal. I am glad this doctor is in your network. Hopefully things will start moving in the right direction for you.


E said...

I am willing to bet that you will ultimately be thankful to those rat-asses at C---- for denying you so often that you found this wonderful doctor. I can see God pointing at him the whole time, gently saying, "Lacie? Lacie?" to Jesus, "She's not listening to me." Jesus: "Look she's out walking again after the doctor told her to knock it off, whisper his name in her ear."

Zipperhead said...

I don't think insurance companies even know how to read, to be honest. :( Maddening isn't it?

Hang in there.