Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)

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Old 05-05-2010, 02:59 PM #1
keep smilin keep smilin is offline
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Thumbs Down my insurance co. has replied about my appeal!!

Sadly.. it is once again ...another denial... They are not approving me for the Ketamine treatment .. grounds being..out of network provider..They ain't budging for ANY part of payment... Thanks for all of your support my dear family..I am going to take some time to digest this news of just a few minutes ago...

Many hugz and thanks again..

Kathy
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Old 05-05-2010, 04:01 PM #2
Jimking Jimking is offline
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Quote:
Originally Posted by keep smilin View Post
Sadly.. it is once again ...another denial... They are not approving me for the Ketamine treatment .. grounds being..out of network provider..They ain't budging for ANY part of payment... Thanks for all of your support my dear family..I am going to take some time to digest this news of just a few minutes ago...

Many hugz and thanks again..

Kathy
Do you have an HMO?
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Old 05-05-2010, 05:40 PM #3
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So sorry for your news.You will be in my prayers. Fondly-Carol
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Old 05-05-2010, 07:48 PM #4
Lisa in Ohio Lisa in Ohio is offline
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Lisa in Ohio Lisa in Ohio is offline
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So sorry, I am sure that this is devastating news, any denial of treatment is. Keep trying, and you have my prayers. Lisa
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Old 05-05-2010, 09:13 PM #5
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Originally Posted by Lisa in Ohio View Post
So sorry, I am sure that this is devastating news, any denial of treatment is. Keep trying, and you have my prayers. Lisa

Thanks everyone... Yes, Jimking..I have an HMO..it's called MVP.. I am just befuddled on how in the world we live in..others who have not the faintest idea nor do they care can make decisions about someone elses well being without even a glimpse or concern...I personallycouldn'tdo it..I'd be broke cuz I would be paying for others health care needs mostly cuz it would crush me to turn my back on someone in need...

Hugz and sleep well my family... Don't worry..I guess I was not mean't to have my Ketamine treatment...

Kathy
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Old 05-06-2010, 12:00 AM #6
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Dear Keep Smilin'
The news of denial are devastating words to hear..

You are always giving everyone hope and encouragement and optimism..
I know you need time to digest this recent judgement..I hope you allow yourself some time to get angry, sad and angry...'cause,friend I am seething..

The Hippocratic Oath that doctors pledge as they begin their practice has these words for the people they will treat and protect...

..."I will keep them from harm and injustice..."

When will these words spill over to the insurance companies who are obstacles to the healing process..

Kathy, keep goin' after that justice!!
love from Hope4thebest
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Old 05-06-2010, 01:48 AM #7
keep smilin keep smilin is offline
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Quote:
Originally Posted by hope4thebest View Post
Dear Keep Smilin'
The news of denial are devastating words to hear..

You are always giving everyone hope and encouragement and optimism..
I know you need time to digest this recent judgement..I hope you allow yourself some time to get angry, sad and angry...'cause,friend I am seething..

The Hippocratic Oath that doctors pledge as they begin their practice has these words for the people they will treat and protect...

..."I will keep them from harm and injustice..."

When will these words spill over to the insurance companies who are obstacles to the healing process..

Kathy, keep goin' after that justice!!
love from Hope4thebest
Dear h4tb..

Well said..!!! I want to re-fill my tank and go after em again..Heck..golly gee...

I do appreciate your very kind words and support...

Love, Kathy
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Old 05-06-2010, 03:34 AM #8
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KS,

To me it would seem that means they have to find an in network provider. Do they have a policy on coverage for when there is no appropriate in network provider ? If they don't have a policy specifically excluding ketamine treatments, I think that is an arguable point.

I know that you must be discouraged now, but sometimes it pays to be the squeeky wheel. If you give up and quietly fade away, they save cash. Wou;d one of your in network docs order the treatment ? I'd try pressure on the insurance company that they need to produce a doc who can perform the ordered treatment. Most insurance companies have provisions for out of network care in certain situations. Try demanding to know what those situations are !

I was so bummed to see your header that you had news with that little thumbs down sign. Boo !
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Old 05-06-2010, 09:20 PM #9
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Dear KS, my friend and buddy;

Relax tape a few deeps breaths. I am very proud of you for fighting this, you have lost the battle but not the war. Allow yourself to feel what you feel, then get down sista!!! I do know where one door shuts......we stand there and bang on it, we get angry, cry, pry, and then we find ourselves on the floor crying and looking down the corridor to the door that is open! Your friend Finz has given you some very good suggestions to sneak in through another avenue! Follow your gut, it is in our weakness that we find strength. Man can tear you to shreads, but God knows what you need. Trust in that, and know that our prayers are with you. I truly beleive they have not heard the last of you, just the fact that they did take the time to ponder over this means they are curious. When your nurse friend calls, have your husband talk to her and tell her you have been locked in your room for days and that he is very concerned! I am feeling better tonight, sit back and enjoy the ride, we have come to a fork in the water and I am going to take the other one. Hang in there girl, you deserve this, beleive it.

A big hug from your little buddy

Jeanie
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Old 05-07-2010, 05:31 AM #10
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Quote:
Originally Posted by Wilbyfree View Post
Dear KS, my friend and buddy;

Relax tape a few deeps breaths. I am very proud of you for fighting this, you have lost the battle but not the war. Allow yourself to feel what you feel, then get down sista!!! I do know where one door shuts......we stand there and bang on it, we get angry, cry, pry, and then we find ourselves on the floor crying and looking down the corridor to the door that is open! Your friend Finz has given you some very good suggestions to sneak in through another avenue! Follow your gut, it is in our weakness that we find strength. Man can tear you to shreads, but God knows what you need. Trust in that, and know that our prayers are with you. I truly beleive they have not heard the last of you, just the fact that they did take the time to ponder over this means they are curious. When your nurse friend calls, have your husband talk to her and tell her you have been locked in your room for days and that he is very concerned! I am feeling better tonight, sit back and enjoy the ride, we have come to a fork in the water and I am going to take the other one. Hang in there girl, you deserve this, beleive it.

A big hug from your little buddy

Jeanie
Good morning.. Jeanie...everyone...


I can't thank you all enough for your support, great thoughts and sweet words... Ya..they have only met me..I have a feeling that this ins. company may well as set me up an application for employment cuz that will symbolize the amt. of time they are going to be spending with me... Although, the NYS dept. of insurance tossed their gloves in yesterday in support of the denial also...
Jeanie..reading your post warmed my heart in the few statements as "Man can tear you to shreads but God knows what you need...and the idea of me being locked in my room..OMG that was sweet and not a bad thought at all..!!!! Sure we shouldn't coast just a bit longer???

Finz..you give me some cool avenues to take and I will need be!!!

Have faith .. this will work out the way it is mean't to be..and if I am not allowed the coverage when it is all said and done it won't be due to my lack of not fighting for it!!

My gloves are back on....

Happy Friday everyone... hugz,

Kathy
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