Health Care Gone Terribly Wrong

I wanted to be clear-headed to write this post.  I wanted it to be perfect because it is, I think, the most important post I've ever written.

Instead, I'm a little foggy brained because my pain level is through the roof right now and I couldn't handle the pain without pain meds.

I ask you, upfront, to forgive the imperfections in my writing today and to read with your heart.  I ask you, please, to forgive the grammatical and punctuation errors I might make and feel my words instead.

My words have never come from my heart more than they do right now.

Four and a half years ago a man ran a stop sign and t-boned my car.  My life was forever altered in a matter of seconds.  Since that time, I've gone through seven surgeries.  I've logged thousands of hours of physical therapy, and I've cried buckets of tears.  

My most severe injury as a result of the car accident was the loss of the use of my right, dominant, arm.  Now, four and a half years – and seven surgeries later, I have around 20-25% use of my arm. 

The loss of the function of my dominant arm has proved to be a challenging obstacle.

The pain I now live in – every minute of every day – is beyond most people's ability to understand.

It was with cautious optimism, I recently went through my seventh surgery for the "trial" of a neurostimulator.  A neurostimulator is a device which has successfully helped thousands of people with chronic pain.

Insurance companies will not authorize the implant of a neurostimulator without first having a patient go through a trial period to make sure it works for that particular individual. 

My medical insurance is with Anthem Blue Cross.

Anthem Blue Cross requires candidates for neurostimulators to also go through psychological screening to make sure they can handle, psychologically, having an implant in their body.

Anthem Blue Cross approved the cost of a pain psychologist consultation for me as one of the necessary steps towards getting a neurostimulator.  The pain psychologist proceeded to "clear" me as a good candidate.

Next, Anthem Blue Cross approved the actual cost of the surgery.

Last, Anthem Blue Cross approved the cost of the neurostimulator device to be used during the trial period.

Yes, it took separate insurance approval of all three steps for me to undergo a trial of the device.

I underwent Surgery #7 two weeks ago today, with the hope for a better life.

The trial was deemed an unquestionable success.  

I can't even put into words the joy (!), the hope (!), and the renewed sense of possibilities I experienced.  This "device" is so much more than a device.  It's a chance for me to live a more normal life.

Finally.

During the one week trial period, my use of narcotic pain meds went down substantially.  The function of my arm increased.   I slept through the night two nights in a row.  Does that sound minor to you?  Prior to the trial period, I hadn't slept through the night once in four and a half years.

Try imagining for a minute, you are living in so much pain you are unable to get even one full night's sleep for four and a half years.  

The device?

Was life changing.

No, the neurostimulator will not give me back full function of my arm.

No, it will not make me pain-free.

What the device did during the trial period, is improve the quality of my life remarkably.  

It also gave me hope.

I wrote a letter to a friend after the trial, telling him all the things I planned to do once I got the permanent neurostimulator implanted.  I listed things I haven't been able to do since the accident four and a half years ago.  

I closed the letter like this:  "2011 is going to be my year of great strides … I just know it!"

I believed, truly believed for the first time in years, I was finally going to get a portion of my old life back again.

Yesterday afternoon, I came home to a devastating message from my doctor.  

Anthem Blue Cross has denied me benefits for the implant of a permanent neurostimulator.

My doctor was angry – and floored.

A "review" doctor from Blue Cross talked to him.  My doctor asked why they would approve the cost of psychological screening, the cost of the initial surgery, and the cost of the trial device and then turn me down for the permanent implant when the trial was a resounding success.

The doctor for Blue Cross?

"Well …," he answered, "I don't know."

If Blue Cross doesn't know why they would make such an asinine decision, who would?

To say I'm devastated, that my hopes have been crushed, that my spirit has sunk to its lowest low … does not begin to describe how I feel.

Why would Blue Cross put me through the trial surgery if they have no intention of allowing me to get permanent help through the use of this device?  

I went through a seventh surgery for no reason?

Help me to understand that.

Why, why, why? 

My doctor wrote a letter of protest to Blue Cross and informed them he would be sending a copy to the California State Insurance Commission also.  I will do whatever I can on my end to attempt to appeal the decision also.

I've never asked anything like this before …

But Internet – I really need your help.

What Anthem Blue Cross is doing is wrong on so many levels.  

I need to find people who can tell me what to do, where to start, and how I can be helped.

I need to draw attention and publicity to my situation.  

How else can one, lone, person fight an unfair decision by a huge, greedy, medical insurance company?

Internet, tell me …

How can I possibly –

Get my hope back? 

** Follow-up to this post can be found by clicking here. **

© Twenty Four At Heart  

67 Responses to “Health Care Gone Terribly Wrong”

  1. Jill

    I just saw your tweet from earlier today and I’m dumbfounded. I’m exhausted and can’t think straight, but the one thing that immediately came to mind is go public. Get on the news. Send your story to every large news station, news affiliate in CA and beyond.

  2. Cate

    I am at a loss for words. I don’t have any real pull being located in NZ, BUT will be praying, cheering you on and retweeting for all its worth.
    Don’t give up.
    [[[hugs]]]

  3. Jack

    Hang in there- we’ll help you figure out a strategy for dealing with this.

  4. Joanne

    fight it girl, fight. Your doctor is on your side, and you have proof it would have helped you. Talk to your attorney, see what your options are, and dont give up!

  5. Michelle

    Like Cate, I can’t help with pull over there being in Aus, but can (and will) pray that the right people are there and able to help you.

  6. unmitigated me

    I can’t help but think that Anthem Blue Cross is putting profits over people. That’s the message that needs to get out, loud and ugly and clear. Talk to the local news, 24! There is usually an ombudsman who can apply lots and lots of public pressure!
    And I am going to link to this post and tell your story on my blog as well. If you are reading and are a blogger? You do it, too! We have a forum never before available. LET’S MAKE USE OF IT.

  7. Lori

    This is just fricken wrong! OMG this makes me so fricken angry. Since I live in pain 24/7 I more than understand why getting this means getting some of your life back. How these insurance companys play with people lives like they do is beyond me.
    I agree with others, try to get on the news and make this known. People need to hear this. I pray that you hear differently very soon. I am so sorry about this. XX

  8. Le

    You are right! This is wrong. I’m glad to hear that your doctor has stepped up to file the first protests. This is merely a symptom of a health care industry gone a stray.
    Please let us know if you find out any more details like who and how-I’m sure your readers, myself included, would be happy to step up and start a “small” email campaign against profit based decisions that do not consider patient’s daily function and quality of life issues.
    My fingers are crossed in the hope that the situation resolves in your favor.

  9. The Mayor

    There does not seem to be any logic being applied here. Dealing with insurance companies can drive any sane person to the brink.
    Don’t give up, that’s what they hope for.
    Lord, grant this woman success in her pursuit of healing & justice.

  10. Stephen

    I’m pissed! Suzanne, there are lots of us willing to help you. First, we need an e-mail address of a contact real live person at the Insurance company. A phone number would be nice as well. Are you willing to put your full name, (some probably haven’t picked it out of your archives yet) and possibly a reference or case # on here so that the people getting the FLOOD of e-mails will know what it’s about? Also the e-mail address of the State Insurance Commisioner in CA. Not sure if CA has it set up that way, but somewhere there is a real live person accountable for legitimate complaints. Call the LA Times and ask for the name of the editor responsible for investigations. Find out which reporter/columnist has been a public advocate in the past. We need that person’s name, and contact info. The Times has clout. We need a list of SoCal radio stations that have a “health segment” and contact info. Go to the KFI website and get the contact info for the producers of the big shows with balls. John and Ken, Bill Handel, etc. (Handel’s producer is a great gal named Michelle) E-mail each producer individually with a gut-wrenching, honest description of the problem. Not sure what the big boy stations are in San Diego, but hit them too. Talk radio is constantly searching for content. If all of us get a list of the above mentioned e-mails and contact info, and then those folks are deluged with righteous outrage, leverage will be maximized. I have to leave right now, but if you need help researching some of this stuff later, let me know. Big hugs for you. Did I mention that I’m pissed?

  11. Chantel

    Oh 24, I am so angry about this! I don’t understand insurance companies and the idiots in the suits who make up these rules! I don’t have any experience with this but I will continue to tweet and get the word out. xoxo

  12. Jenny in MN

    I am hoping that this decision turns out to be a terrible error! It doesn’t make any sense at all. Appeal, get a lawyer if necessary. Keep trying and don’t give up. No common sense what so ever on the insurance company side.
    I am so sorry you are struggling with this! Makes me angry and oh so disappointed and hurt for you.
    I’m hoping that the person that gave you this decision is just maybe really bad at their job. If your case can get moved up, over or to another decision maker – hopefully you can get the approval. Don’t give up hope even when it feels like you have no where to turn.

  13. Holli

    Hi Twentyfour.
    I am sorry you are going through this. I do have a little advice. I used to work for a BCBS company in another state and know a little about how things work.
    1. Find out the name of the medical director for Anthem Blue Cross and have your doctor send an appeal to him/her addressed personal and confidential. That will ensure that no one else will open the letter and ship it to another department.
    2. Get a copy of the denial letter. It will have to explain why they are denying it. Do they consider it experimental? Just not covered? Have you met your maximum for the year? etc. Depending on what the answer is contact a lawyer. Was the trial surgery deemed a diagnostic procedure? I doubt it was, but you never know. As I said, I used to work for BCBS, I also worked in the authorization dept for an HMO. Let me know if you want to talk to me. Send me an email with your phone number if you do. Good luck. I will keep your situation in my prayers.

  14. Chris

    Over a decade ago I worked in the Quality Management of a very large HMO on the mental health side. I can tell you that automatic outright denial of treatment is the norm. It is the only way they can stay in business. I’d recommend talking to someone in your HR. They have contacts with the managers who write the policies & basically want to make sure your company renews its plan. If they make a stink, someone should walk over to either your case manager or QM & get this approved. If that fails, find your benefit book (which may be online) and look up Appeal Process & Formal Grievance process. It is important to use the term Formal Grievance. This goes to the big wigs in Sac, but even it is flawed. I hope that helps. We really need to get insurance out of health care. They are opposed forces.

  15. missy

    KNBC has their consumer reporter Joel Grover, who seems to be quite effective. Send him an email too. I am so sorry to hear this news, but don’t give up. As you know with insurance companies it’s all deny, deny, deny and maybe you will just give up. But we all know that’s not your MO. You will get the surgery.

  16. di

    Contact everyone possible. Get your story out live to news channels. What BCBS Anthem is doing is WRONG! They allowed you to be nothing more than a guinea pig, and a successful one at that and NOW decide to deny?? This sends chills down my spine. They obviously don’t know who they are dealing with…. the internet world…. I say we all bombard them with negative press on our blogs…. going to write my post up NOW.
    Di

  17. Issa

    Oh honey, I have no idea where to begin…except that I suggest you send this post to your local news station. Send it to the top people at Blue Cross. Send it anywhere and everywhere in hopes that someone figures out how to help.
    Our insurance is so effing messed up in this country. I can’t even believe how bad it is. I’m so sorry that you have to bear the brunt of it’s stupidity.

  18. Redneck Mommy

    As a Canadian, I am of no use to you here. I have no ideas the ins and outs of dealing with what seems to be the jacked up medical insurance system you Americans are forced to endure.
    However, I can tell you the squeaky wheel almosts ALWAYS gets the grease. So start squeaking baby. Appeal that decision, get your doctor to make noise, call the media, whomever. I wish I knew who to point you to so that your squeak could be amplified with a bullhorn, but alas, I’m in the wrong country.
    What I do know, is this is a ROADBLOCK. Not a dead end so do not treat it as such. Not yet. This dumbassed decision is an obstacle to your goal, but come hell or come high, you will reach your goal and get your implant.
    Do not give up. Don’t.
    Fight like mad baby, and I’m here cheering you on.

  19. Comfortablyme

    Other than twittering the hell out of your story all I can do is pray. I plan on doing both.
    I can’t believ you were denied. Well, I can because my husbands WC case was denied years ago because they felt that CTD was genetic.
    I hope this gets straightened out quickly.

  20. NeCole

    I agree with Stephen; contact your local newstations and work with their consumer complaint segment producers. They air stories like this and it seems to make a difference. Additionally, I would recommend that you contact the California Attorney General’s office. Between the CA Insurance Commission and the AG, they should be able to put a stop to Anthem’s hinky behavior.

  21. Nikki

    This sucks. Be noisy. Commenters already have made some of the same suggestions I was going to make: contact your state’s department of insurance and contact your local news. Next? The California attorney general and even the governor. Next? Your elected representatives on the state and national level. Next? The national news agencies. Send everything by certified mail, return receipt requested, and keep copies. Then you can establish your paper trail.
    Good luck to you. I hope and pray that BCBS gets their heads out of their asses.

  22. Kristen

    My dear friend, you’ve gotten a boatload of good advice. I want to volunteer myself, like I told you last night when this was so fresh and upsetting, to be your coordinator, ombudsman, contact, spokesperson, advocate – WHATEVER YOU NEED NOW. All of the comments contain amazing advice. Now, we need to make it happen. You start the ball, and we’ll make that baby ROLL. It’s going to be ok. I said it last night, and I will say it again – THIS IS NOT OVER!

  23. Lou

    I’ve had a relative go through similar absurdities with Blue Cross. Email me, and I’ll share stories of how she got the immovable object to budge. (I’d share here, but it is hard to type on this device.)

  24. Gurukarm (@karma_musings)

    Not only contact TV stations, but find out who the consumer advocate columnist is for the biggest newspaper in your area, and get that person to write about you. Here in MA, the columnists for the Boston Globe have made a difference hundreds of times for people on their last legs who are being screwed by the system – I’m sure some one of them in your area would be interested in your story.
    Best of luck to you, and please let people know how it develops. (Here b/c of Tanis the Redneck Mommy’s post at Facebook).

  25. EG

    I agree with some others, contact the media… if they think that you will in any way embarrass their company, they will give you what you want just to shut you up and not make them look bad to their clients. I hate insurance companies… corporate America. They are only worried about their bottom line and the billions of dollars they make each year. Nevermind those of us who are in one way or another suffering… Praying for you!

  26. Jaynelc.wordpress.com

    Wow, I’m blown away by this, so much for the land of the free, eh?
    Here in the UK we have the ‘privilege’ of free healthcare, and I’m not going to insult you too much by moaning about our lot as it seems that you guys have it SO much worse, but we had a situation a few years ago where my Grandad needed some injections for his Macular Degeneration which were going to stave off his impending blindness, and he was told that he would have to pay £10,000 for them on the NHS.
    Naturally, he paid, but about 3/4 of the way through, they told him, “Oh, you don’t have to pay for these in this district anymore, but you won’t get the money back you’ve already paid, and if you’d gone to the hospital 10 miles up the road, you’ve have got the whole lot free”. We have this shitty postcode lottery to contend with.
    I don’t think any health system has it totally right :-/

  27. Lu@masmom

    Suzanne I am so sorry you have to go through more bullshit. This is infuriating to say the least. Fight the man and keep pushing. They simply MUST clear this surgery. ANything I can do, I will.

  28. Jen

    I am a pain medicine doctors. You need to send your complaint to the Insurance Commissioner of California as mentioned, but make sure you don’t have a self funded plan through your work. If you are self funded, you have no possibility for appeal and the plan is not regulated by the insurance commissioner.
    You need to know the diagnosis code being used, wrong codes are automatically denied.
    If it is a spinal cord stimulator, they are FDA approved for pain, so your doctor should be able to push it through if they call.
    If it is a peripheral nerve stimulator they are not FDA approved for peripheral neuropathies and you will have a harder fight. Your doctor need to find at least 2 articles supporting the use of this procedure for your condition.

  29. Mariah

    keep fighting, keep talking about it on the internet! Contact your local news, write the papers. If I can help please let me know! As of now I will Tweet and refer people to your blog! This is ridiculous!

  30. Alyssa

    As *absolutely HORRIBLE* as it sounds, this is completely common/normal when it comes to a major surgery, especially with an implantable device & an insurance company. As others have already suggested, start the appeals process by gathering all your records & having your doc write a letter of medical necessity. Another thing that may help is to contact the company who makes your neurostimulator-they often have some sort of nurse/case manager who acts as a liason between the doc offices & insurance companies & can expedite approvals.
    How do I know all this? AFTER I had my VNS (Vagus Nerve Stimulator) implanted into my chest/neck in Feb, BCBS tried to deny the $60,000 surgery they’d already given prior-approval for. We had to come up w/documentation as to exactly WHY I had to have the VNS, since it’s not FDA approved for people w/my type of seizures, but in the end, it was approved.

  31. nuckingfutsmama

    OMG, this is absolutely horrible! I can’t believe you went through all that to be given this devastating news. All the commenters are right — use your voice as much as you can. I tweeted a link to your post, as I’m sure many others have as well. Keep fighting & don’t give up! Sending you prayers & hugs….

  32. Lara

    Your doctor will be your biggest ally. I would search for a medical attorney who will handle your case Pro Bono. Call the Bar Association in your area for a list of lawyers in your area who handle cases like this. You need a letter from your doctor stating medical necessity. You need to document how difficult your life was before and how much better it was on the trial run. Demand a letter in writing from Anthem stating WHY they denied your claim. Keep a copy of everything you send to them and everything you get back from them in chronological order. Every person you speak to, get their representative ID # and name. Hold everyone you speak to accountable for what they tell you. Let them know you mean business.
    My mom has MS and I have fought Medicare and those assholes at Anthem over some of the most ridiculous crap for years. I hate them all. I won an appeal in front of a Federal Judge against Medicare w/out a lawyer. The paperwork and phone calls are exhausting, of course when you’re feeling your worst, but you HAVE to do it.
    I am so sorry you are going through this. If you need any help in writing letters, etc… please email me!

  33. Becky

    Fight, fight, fight, fight, fight. I had to do that with a $40,000 NICU bill for my twins six years ago. It helped to have the doctors on my side. I hope it helps you too.

  34. kitterztoo

    Follow Holli’s advice. I’ve dealt with BSBC and have done what Holli suggested with varied success. If your appeal process doesn’t work, you can appeal to your congressman and see if he would intervene. I’m not a candidate for neurostim, but know how well it works.
    I wish for you the strength to go forward with the appeal process. When I had BCBS, I was able to get the appeal process to work for me. Don’t ever give up. You deserve a life without pain.

  35. Jan

    The suggestions made by Stephen and Holli are excellent – take their advice. Also, do not underestimate the importance of just what you’re doing: taking advantage of social media. Continue to blog, Twitter and Facebook about this. People will pick it up and carry it forward, and BCBS is going to end up with a great deal of egg on their face.
    You WILL get your implant, Suzanne. We’ll help.

  36. Kimberly

    I have dealt with Anthem for years and although I have not been in your position, I have been frustrated beyond belief with them also. It gets even more ridiculous because my husband works for a CA-based company yet we live in NY. All the claims flow through NY AND CA which makes the entire process even longer and more ripe for issues.
    You have been given some good advise. Shout out your story from the rooftops! In the meantime, I will share your story and send you my most pain-free wishes! Good luck to you.

  37. Andrea

    Most people have already suggested my thoughts – contact state representatives, attorney general, insurance commission, news stations. Anyone you can think of. I would have not just your doctor, but your family and friends write letters on your behalf, describing how your quality of life during the trial improved. You know that all your blogger/twitter friends will keep this moving around the web – we’re on your side, lovely. Don’t lose hope – we’ll be praying for you and thinking of you, and crossing our fingers that things work out. <3

  38. steve

    Looking at it a completely different way: how much does it cost to have the surgery done?
    I agree, the insurance company should be run better, and should pay, etc. etc., but let’s cut to the chase.
    Once you have the surgery, and you have less pain, THEN you can make a hobby out of making Anthem accountable.
    Maybe we could all chip in a few bucks, and get you the surgery you need.
    Then you would have time to:
    find email addresses for all HR directors at every major organization and company, and email them your story so they don’t consider Anthem as a provider
    raise money for a Wall Street Journal advertisement telling your story (hopefully full-page, but 1/4 page would probably do)
    open your CafePress store with t-shirts that say something like “ask me why Anthem sucks”
    and those are just a few ideas, more will come to you.

  39. deb from p.s. bohemian

    Here in WA we have a state ombudsman office for health insurance. I had to lodge a complaint with their office when our insurance company would not approve neuro testing for my son who did turn out to be on the autism spectrum.
    here’s what I found for CA “http://en.wikipedia.org/wiki/Health_insurance#California” and the link to the actual organization: http://www.opa.ca.gov/
    I so hope these offer you some assistance – I’ve lived with chronic pain due to fibromyalgia for years now – I will understand how much it sucks and I can imagine the devastation you are feeling at having this option ripped from your hands!

  40. misha

    Hi there! I came over from The Blue Ridge Gal!
    Insurance probs have been a part of my life too.
    In 2004 I was recovering from back/neck surg. I had a 6 month recovery process with intense PT. (After years of working in the professional horse business, my body had really suffered.)
    The day my hub and I were on the way to my final doc appt ( to be medically cleared after surg and PT) we were hit broadside by a semi that ran a light and was traveling at a speed of 70 mph.(He was drunk and is now serving time for other offenses! He also had no insurance and was self employed)
    Had it not been for the car, a brand new BMW w/ front and side airbags, my surg remarked that my still fragile neck prob would have broken on impact.
    After 4 more surgeries, I thought life was turning around. Until one day I could not get out of bed. The pain was unbearable, and even though my brain kept telling my body to get up-it didn’t connect.
    And so began my journey. A lot happened in between but finally in 2007 I was diagnosed, at the Mayo Clinic, with Fibromyalgia and Connective Tissue Disease. Had the accident never had happened I would not be afflicted with either. It was the compression injuries, and the following surgeries that put my body where it is now.
    And that position is dealing with intense pain on a daily basis.
    I had a wondeful team of doc’s and therapists who worked with me to ensure I would not become bedridden. Which is where I was headed.
    In 2007, with this crappy econmy, my dh lost his job. And we lost our med. insur. And now No ONE will insure me!
    The last insurance company I applied to actually sent a letter back to my physician stating that the scan results, and records from Mayo etc. showed my body to be a “complete train wreck”. Their words! And they condsidered me uninsurable.
    So be it. For now we “cash pay” all my med stuff. Yep, it is way expensive. But, I am so blessed to have a doc with a local hosp. system that even lets me do this!
    Days are hard. Nights are worse.I have intense insomnia and the pain, well, you know (!) keep me from sleeping.
    We live on a beautiful farm in east Tn with 5 horses, dogs and cats! I work in the barn each day and just plod along. For now.
    I will following your story, Suzanne. I agree with other comments. Get your story out in the news! It works!!! Make your own video and send it to news stations if you have to!
    You deserve to have what BCBS promised. A pencil pusher, using their *right arm* shouldn’t be able to deny you the chance for a more productive life. And isn’t this what good insurance companies are supposed to help us accomplish?!
    Hoping the best future for us both!
    misha
    p.s. i didn’t spell check a darn thing!

  41. Sandi

    I will donate money to help you get this surgery. Fuck Anthem. Get a paypal link on this site ASAP and lets get this done.

  42. Sarahndipitea

    I am not much help, but I wanted to say that I know how your body feels. I have been in the same boat w/chronic pain for three years now and am feeling hopeless at this point. Your blog helps make my decision to stay with Kaiser and avoid Blue Cross at all costs.
    I wish you the best and hope that you are able to find some respite and get some true rest soon.

  43. Jennifer Jaff

    Hi. I’m a lawyer and I run Advocacy for Patients with Chronic Illness. We do free insurance appeals. If there are any appeals left, we would be happy to help you. We will need a release so we can collect all of your medical records and represent you in the appeal. You can reach me at patient_advocate@sbcglobal.net or 860-674-1370. Thanks.
    Jennifer C. Jaff, Esq.

  44. Linda Tustin

    Suzanne- I can’t help in any way except to say- If I can help just ask. Anything… (((gentle hugs)))

  45. vodkamom

    I don’t know what to say either- like so many others. I WILL say that I hold you in my thoughts and prayers, and hope that SOMEONE will see the light and get that device for you.

  46. Josh Mullen

    I had a similar experience, and had consultations, MRI’s and surgery a few years back, all compliments of Alberta Health Care. I’m 100% today and didn’t see a single bill, and didn’t have any problems getting service. I had to wait three weeks for the MRI, but that’s ok. I was on Oxycontin and Vioxx (yes! THAT Vioxx!) for quite some time, but have been drug free now for years. People love to complain about the Canadian Health Care system, but I think it rocks! I hope the US gets a good health care makeover, because health care should belong to the people: NOT insurance companies and NOT the government!

  47. Karen L. Alaniz

    How do you get hope back? I don’t think you ever truly lost it. There is somewhere within you a spark that is still capable of creating an inferno. It is only grief over the yet-unfulfilled dream that has hidden that spark. But I implore you; look for the spark. It’s there!

  48. Annie

    I am not sure what to do, but I know you need to fight!!!! I also think that getting lots of press could help. I will keep you in my prayers.

  49. C. Patton

    The best advice is use the MEDIA….get your story out there. Big companies do not like negative media. Stay strong, keep up the fight.

  50. andygirl

    found this post from another blogger and I have to say I am floored. this is absolutely not okay. this is 2010. we have modern medicine. but why can’t people in the richest nation in the world get access to it? not okay. I will spread the word.
    I am so sorry for your pain.
    Andy

  51. Alex@LateEnough

    I am so sorry. How awful. I haven’t read all the comments but having your doctor on your side helps. A lawyer. Even if they just send a letter on the firms letterhead helps. News stations. Write your congressperson, local, state, national.
    And keep getting the word out.
    My thoughts are with you. Chronic pain is a terrible thing.

  52. Skyler

    Sounds like you’ve got a lot of help via Internet already to get this thing resolved. Just one more thing you may want to try and that is having your pro bono lawyer sue Blue Cross for putting you through an unneccessary surgery! A totally different suit!
    Good luck and keep us posted. I have a feeling this is going to be a piece of cake. I hope!

  53. Cathy B.

    Another Canadian here, can’t give you more concrete advice than everyone already has, but it looks like there are some very useful comments. I’m sending my positive thoughts for you, hope this ludicrous turn of events is only a blip that’s soon history!

  54. Jane

    Insurance companies just don’t think or care about the psychological impact that an automatic first denial has on people.
    My daughter works for Coventry Health and says that this is normal. Make an appeal (they have a process for this) and it will, in all likelihood, be approved the second time.
    They are hoping you won’t pursue it.
    I can’t even imagine how you feel right now. Some insurance companies really are the devil’s helpers and Anthem Blue Cross is one of them.
    As others have said, your doctor is your greatest ally here. He sounds wonderful and his letter will probably do the trick.
    Keep your chin up and maybe have a margarita or two. Tomorrow will be better.

  55. Kelly

    I get here late one day and look what happens? I am SO ANGRY for you. You can appeal. You WILL win. In the meantime, scream from every rooftop and don’t give up! They WANT you to give up so they can save money on their end. You’ve overcome alot and you will overcome this 24!

  56. Tami

    You’ve gotten some great advice but WHY should anyone have to go through this? Especially when they’re not 100% and NEED medical help? The system is so broken. : (

  57. steff

    this news makes me sick. stories like this push me in the direction of wanting to leave this greedy misdirected nation behind in favor of one that actually puts its citizens first, INSTEAD of big business. i know great strides are made everyday to correct the wrongs of those who lead us down the wrong path in the past but this is just unacceptable. i agree with many of the other commenters who mentioned contacting local new agencies. this is exactly the kind of story that they would love to have and that people NEED to hear.
    i will keep you and your plight in my thoughts. wishing you only the best.

  58. Rob

    Why, why, why?
    Because corporations are people, too! Our Supreme Court has ruled so!
    We all know people that manipulative, sociopathic and enjoy leading us on and then jacking us up, for their amusement?
    Corporations are just like those people, only better at it.
    My ex should have been a megalo-CEO.

  59. Judy Schwartz Haley | CoffeeJitters.Net

    Insurance companies are evil. Health insurance reform did a little to curb the amount of evil insurance companies can do, but no enough.
    I suggest you forward this blog post to all the major TV news outlets in your area. Most local TV news stations have an on staff reporter who focuses on righting wrongs and outing corporate jerks that are hurting their customers. see if one of them will take an interest in your story. Also send it to the newspapers.

  60. Ken O

    Be thankful you weren’t born with this disability, like I was born with mine. Now set your jaw, grit your teeth, and deal with it. Hope for the best, expect the worst.

  61. Cassy

    I just stumbled upon this post, and I think this is terrible. You have my thoughts and prayers. Best of luck to you, really.

  62. salome riingen

    Do not give up! If something is wrong, there’s a way to make it right. Just remember that success will not happen by accident. You have to believe that you can be helped….just do not stop your research your case. Hope for the best thing to happen for you.

  63. Ken

    Suzanne

    I noticed this was written on October 20, 2010. Any updates?

    I too may be eligible for a neurostimulator. I have been going to pain management for some time but I recently went to another urologist for a 2nd opinion for my chronic pain as the first was just referring me to pain management. The 2nd doctor said there IS something they can do, She will be doing surgery next week which has a 50% chance of stopping the pain. Pain management said they would do a neurostimulator if I was one of the 50% that it did not work for.

    Since I too have Blue Cross, I am interested in the final results you had with them. (I have federal so it may help some) PLEASE update us as I am sure others here would like to know too

    ken

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