Thread Tools Display Modes
Prev Previous Post   Next Post Next
Old 11-18-2015, 06:23 PM #6
northerngal northerngal is offline
Member
 
Join Date: Feb 2011
Posts: 179
10 yr Member
northerngal northerngal is offline
Member
 
Join Date: Feb 2011
Posts: 179
10 yr Member
Default

I did not involve the FDA at all in my appeal process.
I researched rituxin and printed out several cases in which it was effective to use as examples. I got a letter of support from my doctor, stating that she recommended it as the next step for me. I copied several pub med and other reputable articles regarding rituxin.
Even with all the above information, my written appeal was denied. I then requested a phone hearing. I had all of the information in front of me during that hearing. Like I said in the above post, I feel it was more my knowledge on my condition and treatment options, and the fact that the doctor on the board from Anthem BCBS had no experience with either, is what won the case for me.
My best advice is go to the hearing prepared, you have a lot of knowledge regarding your condition. Research the treatment/ medication you are looking to get and give them examples similar to your own where it has been successful. Make them aware of other treatments/medications you have tried and failed----especially if they are first line treatments.
Insurance companies always want to assure we have tried first line, less extensive, less expensive treatment options if they are available.
northerngal is offline   Reply With QuoteReply With Quote
"Thanks for this!" says:
echoes long ago (11-19-2015)
 


Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
compassionate allowances for SSDI chasmo Parkinson's Disease 2 10-28-2008 02:58 AM
California Compassionate Choices Act BobbyB Survivors of Suicide 2 03-29-2007 12:16 PM


All times are GMT -5. The time now is 07:32 AM.


Powered by vBulletin • Copyright ©2000 - 2025, Jelsoft Enterprises Ltd.

vBulletin Optimisation provided by vB Optimise (Lite) - vBulletin Mods & Addons Copyright © 2025 DragonByte Technologies Ltd.
 

NeuroTalk Forums

Helping support those with neurological and related conditions.

 

The material on this site is for informational purposes only,
and is not a substitute for medical advice, diagnosis or treatment
provided by a qualified health care provider.


Always consult your doctor before trying anything you read here.