The Saga of #137: On Tuesday, I told my helpee that Aetna was done with us, and we needed to take the fight to the employer. On Thursday, the employer decided to pay for the hospitalization -- but not the surgeon. Employer said, If you want to get the surgeon paid for, you need to go back to Aetna, and get them to approve it. Getting the hospital approved is nearly a total win. She is authorized to get into the hospital next week ... and they can manage to pay cash for the surgeon part if they have to. Last night I wrote a THIRD appeal, to reflect the new developments. I also told my helpee last night that I was done. They would need to carry the ball themselves on Friday. This was not a strategy. However ... in retrospect I would say that it was absolutely the right and most effective thing to do. So ... on Monday Dr. Sugarbaker has to take time from saving lives to talk to another idiot doctor at the insurance company -- to convince him as to why he needs to be the one to do this surgery. Rani is going to have her surgery. We may actually win this whole case. I am pretty bruised and battered from this one ... but Im feeling better already.
Posted on: Sat, 05 Apr 2014 00:28:15 +0000
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