Appeal sent. Now what?

TL;DR: My insurance company is still being awful. I turned in an appeal that has over 200 pages of supporting documents. Hopefully they’ll grant the appeal and I can get on with my life!

Here’s a rundown of everything that’s been happening:

My insurance company doesn’t want me to have my tumor removed by Dr. Ferreira, who is the foremost expert in Washington (and one of the top in the entire United States) in pituitary tumors. He is literally listed on their own website as an in-network doctor—a fact that I had to prove to the case manager the insurance company assigned me to, since he didn’t believe me—and my neurologist, Dr. Zhang, specifically requested that Dr. Ferreira be my neurosurgeon.

Here’s Dr. Zhang’s letter so you can see it. She’s an amazing woman who is fighting for me.

Instead, the insurance company wants me to use a neurosurgeon named Dr. Azeem at the facility they own and operate. I went to see him and learned that he wanted to do an open craniotomy. For those of you following along thus far, the craniotomy Dr. Azeem wants to do would be much bigger than the “keyhole” craniotomy I would have had done if I had had an aneurysm. Dr. Azeem would cut from the center of my hairline to my ear and remove a large amount of skull.

Dr. Azeem’s plan would be the most invasive approach possible, whereas Dr. Ferreira’s plan would be the least invasive. Since the transnasal surgery is about half the cost the keyhole craniotomy would have been, I have to think it would be less expensive still than the open craniotomy!

Plus, the recovery for an open craniotomy is enormous compared to that of the transnasal resection. Why are they doing this???

Add to that the fact that the longer they make me wait for surgery, the more likely it is that I will lose more of my vision and not recover the vision I’ve already lost. This has been confirmed by both neurosurgeons.

I am at my limit right now. My level of frustration is such that any little thing makes me cry. Not sad tears, more like…rage tears. I am full to bursting. I’ve had it up to here. (Add your own relevant platitudes).

My appeals have been filed. I opened a case with the Office of the Insurance Commissioner of Washington State. Now all I have to do is wait……………………

Being done with my appeal is more agonizing than I was prepared for. Being busy was hard, but it was keeping me from drowning in all of the anger and dread that I feel. I’m not up for pixeling today. I’ll snap out of this funk soon.


2 Replies to “Appeal sent. Now what?”

  1. Have you filed an appeal with your insurance company? Which company is it? I’m a friend of Ann Wright-Mockler. I write insurance appeals professionally. If you would like help, I am at your service.

    1. Hi, KyriAnne 🙂
      I have filed an appeal, filed a report with the OIC, and contacted my local representatives! It seems like things are finally going the right way. Thank you so much for your offer.

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