Wednesday, July 14, 2010

Got my Grump On!

So, I have had this week off and made a goal to write a appeal/letter to the Insurance Company and Insurance Commissioner. So, I did! Speaking with the Oral Surgeon folks yesterday they gave me some inspiration to take a run at them. So this morning, after doing a few other chores, I sat down and got my "grump" on! I pulled out the insurance contract and began to dissecting the coverage claimed in the contract. To me, it seems very clear that they should cover some of the hospital stay. Although, it is very clear that they will only cover a whopping $1,000 for the orthognathic surgery part...but it states in the same coverage that related hospital stay is covered. I am sure that they will claim that both surgery and hospital coverage is only $1,000 but that is why I sent a copy to the insurance commissioner! Having the insurance commissioner in the mix will provide an advocate for me to keep the insurance companies honest! To me, it seems to be bad faith to say you will cover related hospital services and only cover $1,000. I can't think of any hospital service that would be less than that! We will see, wish me luck!

6 comments:

  1. Sending a little hope your way... it will get approved. don't worry... just pray. God will provide.

    :)

    -makay

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  2. Brent,

    Hello! I really feel for you, in regards to the insurance process. I went through a MESS getting my surgery covered, although I was lucky enough that my school district covered it. If you need help, I have all of the appeal letters written by my surgeon/orthodontist/myself that I presented to the board of directors - they're also on my blog in the months preceding my surgery (July 1 2009).

    Good luck!
    Steph

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  3. Go get 'em Bubba! If anyone is smart enough to to go head-to-head with them and get this taken care of - it's you!

    XOXO

    ~me

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  4. Good luck!!! Fingers crossed.

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  5. good luck, hopefully all works out =)
    -maya

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  6. Good luck! And thanks for the good wishes. I'm the first few days of healing and I can't wait till I'm i the clear. :)

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