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jewel swanson
April 27, 2011
denial of needed health appliance
I have a condition called lymphedema and a letter of medical necessity was written via Dr. Ellen Tedaldi one of Temple University Hospital top doctor in this city of brotherly love for a medical appliance.The letter was sent to blue cross and blue shield of center city Philadelphia.The initial contact started ?2008, two years in the process. I have been seen by a physical therapist as well as a lymph therapist trying to control my condition. My leg is getting bigger and more painful, especially when I walk. I am seeking your much needed help regarding this matter as blue cross and blue shield have shut the door in my face for a product that will keep me from becoming a cripple.I have been denied my appeals for the leg appliance by the people / panel who works for blue cross and blue shield. The insurance company admits that I have lympheda but they denied my claim because my lymphedema is a DIFFERENT LYMPHEDEMA which is ridiculous, Lymphedema is lymphedema if you get burned by fire from the stove or fire from a match youare stilled burned. Legitimate denial of a medical claim is one thing but to be denied a claim by a panel of people who is paid by blue cross and blue shield ( from whom i am seeking the appliance ) to deny the claim is very criminal.The panel seems only exist to deny claims, I now that this is not an academic explanation but this is the cheating behavior of the insurance company i paid faithfully for the last 15 years or more, I feel cheated and raped by thir decision of denial, would you and your team of investigative reporters go to blue cross / shield and see why their denial rate of medical equiptment is so high. I am becoming a cripple fast without the appliance, my leg is painful and is slowly growing as i sit to type this email . I need some help in fighting this big insurance company. The insurance comp said that their appeal decision of denial was final, Ineede three on my side please help me Mr Donovan
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ltp132
January 5, 2011
unable to receive medication
I went to WalMart to get medication and was told your insurance had been terminated so i tell them thats impossable cause i am still paying my premium which comes out of my check before i receive it try to call blue cross they said i need to call my job so know after being at wal-mart for three hours i have to figure out what happened. I call my job and leave a voice - mail, i wait an hour and call back still to receive voice-mail now i decide its time to try someone else . I ask for the buisness office manager she states they had got my message and was working on it, about thirty minutes later the payroll women calls me and states they cant get a holod of anyone so they suggested i pay for it out of pocket and let blue cross reimburce me. Know let me ask i dont know about everyone else but in this economy i do not have a spare hundred and twenty dollars laying around, could i have put it on my credit card yes but whos going to pay the interest when they decide to send me a check.
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