I am NOT having the operation tomorrow.
At midday today, I got a call from my radiologist that Blue Cross would not cover my operation. We spent the afternoon working with the doctors to try and get through an emergency appeal, but they couldn't make it happen in time for Wednesday.
The out of pocket cost to us would be in the hundreds of thousands of dollars so we need to get the coverage approved first. My surgeon said he has done 120 of these and they've all been covered, so we are all very frustrated.
We will go forward with the appeals process and hopefully reschedule soon.
Needless to say we are not happy, but this is the situation, so now we deal with it...
I'm so sorry- I hope everything gets squared away!
ReplyDeleteMissed you today!
Jes Stout
Such a bummer! SO sorry....
ReplyDeletemuch love
J & D
PROCESS, ...NOT people, persons, or personalities, ...hang in there, given your DR.'s "experience", the paperwork will PROCESS and you'll have the opportunity to continue the hard fought battle. The "sully's" are with you!
ReplyDeleteprift, i'm sorry about this snafu, but your surgeon sounds legit and i hope the coverage will work out.
ReplyDeletexo diane
Prift so sorry about the bad news, hope you get some good news soon. Thinking of you always
ReplyDeleteShannon Dalton
And there I was watching Mitt Romney on David Letterman bragging about the wonderful healthcare for all persons and things in MA while I wished we had that here....Oy! That sucks.
ReplyDeleteBut I suppose, as they say, things happen for a reason. Well, I hope the insurance scoundrels get it together...Ugh. But just a little bump on the road of your fair greater journey of magnifigance.
xxoo
Korndingo
This is just crazy. I have such a hard time understanding it. It just seems so unfair, and wrong. I really hope you get it covered, and that you can stay positive and focus your energy on getting better instead! Kramar
ReplyDeleteI know it's important for you to stay positive so I'll spare my thoughts on Blue Cross, thoughts I've had well before this update from you. That being said, and time being of the essence, we need to figure out a fund raiser to get things going -at your school, this site, everywhere. Someone, other than you needs to contact everyone to get contributions underway. The other necessary strategy is to contact the media far and wide about this to publicly smear Blue Cross for this decision and quickly. love, (as always) Anne (contact me for anything I can do)
ReplyDeleteHey Dave,
ReplyDeleteI had no idea that you were sick until I read your status last night. I have been catching up by reading your blog (thank you for writing it.) I hope everything works out soon with the surgery. I'm planning a visit to MA in the summer and would love to get together. You'll be in my thoughts and I look forward to reading your good news!
If the insurance doesn't come through within a reasonable time, consider have a benefit. I know it would take quite a bit of fundraising to cover the cost of the surgery, but you are a well-loved and deserving man who teaches in a town where good people have money to put to good causes. In the town where I teach we have benefits fairly often to help with medical costs of school staff. Much love & prayers going out for you. Tami (Sanderson) Breazeale
ReplyDeleteI think someone from your school who reads this blog should talk to the school about setting up a paypal account (very easy to do) for your needs. Then there should be a notice about it on the school's website, this blog, a message to every facebook friend and every other outlet and community your tapped in to. If 1,000 people donate $100, it's on the way. There should also be an actual fundraiser somewhere with tv and radio news invited to tell the story of why it is necessary. Trust me, the more public this is, the more likely Blue Cross will hurry to come around. Anne
ReplyDeleteHelp out by forwarding blog to news stations to investigate and help out.
ReplyDeleteStrike 1M and counting for the insurance companies! Hopefully BC will get smart soon. If not, you have a village behind you that can make things happen! Rosie and I send our best wishes!
ReplyDeletedave,
ReplyDeletei think you need to call BCBS and simply say "do you know who i am?"
Me thinks they don't know who they're messing with....i'm sure this is just a bump in the road to the prize.
good luck,
alan and jan
Dave,
ReplyDeleteUnbelievable but not surprising given the nature of healthcare payment systems.....but, merely a temporary fog from which you will emerge still as ready and focused to keep going.
Stay strong.
All my love,
Paula
Hi Dave-you are loved far and wide-i dont know you well-but my daughter lusts for your class-i swung by the Clark yesterday and show looks fab-yours are stand out-
ReplyDeleteHelp, $$$, will come if BCBS doesn't-
also-I totally agree w/Anne on the media front
wish you the best
Carlisleans