Friday, November 6, 2009

It's In The Mail...Almost

I guess I finally calmed down enough to write an appeal letter to my health insurance provider. I tried to be as nice and as calm as I could, and I think I succeeded too well. I may have been too nice. Here's the letter:
To Whom It May Concern:
I am writing to appeal the denial of my appeal of your original denial of payment for treatment of Multiple Myeloma using an allogeneic stem cell transplant. Your letter states that the denial is based on the treatment being a phase II clinical trial, trial number NCT00683946, despite being assured by my oncologist that this treatment is not a part of this study. Your letter states that a photocopy of the Plan provision on which this denial is based is enclosed with this letter. No such document accompanied the letter I received. I request that you provide me with this document.
The reason for denial remains vague, at least to me. Is it the procedure itself, the drugs involved, one of the drugs, all of the drugs, some combination of the drugs? Is the denial based on the allogeneic stem cell transplant? Please enlighten me as to the reason for the denial other than the claim that the treatment is experimental.
I also request that you send me copies of all relevant documents and information on which this decision was based. I also request that this information, if it has not already been given, be provided to my doctor,
I await your response.

I omitted my doc.'s name and address, for his privacy. I also omitted the name and address of my insurance company, only because I am holding back should I need to use it later. Believe me, if it will help I will make them known. This fight has just begun and I am as stubborn a human being as ever lived. I'm fighting for my life and I will fight as hard as I must, using whatever I must to get justice. After all, am I not paying them? I thought about this, am I not living up to my faith, am I being vindictive? While it is hard not to be, I also decided that I am not fighting just for me, I am also fighting for all those in my situation, those who for whatever reason can't fight back, or have been intimidated into not fighting. Perhaps my fight will in some way help them. I hope that in some way God is using me and my fight to help others. If so, this is all worth it in the end, no matter what that end may be.
Deacon John
Friday of the Thirty-first Week in Ordinary Time
Nov. 6, 2009
St. Peregrine, Pray for Us.
Blessed John XXIII, Pray for Us.

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