Help for a fellow patient.


Posted by Alan Phair , May 23,2001,17:08   Archive
I have been speaking with Virginia Hill, a BEB patient who has been going through a tough time. I had originally spoke with her several months ago and helped convince her to look at having a Myectomy done. She finally got up the nerve to schedule one with Dr. Anderson and has a tentative date of June 14th. She has run into some stumbling blocks and needs some assistance. She does not post on the board but does listen in. I told her that I would "let my fingers do the talking" for her. She is having a hard time getting her insurance company to give the ok to pay for the operation.

She has Horizon Blue Cross/ Blue Shield of New Jersey. I was wondering if there is anyone out there who has Horizon even if it is not from New Jersey so that she could have a precedent to show her insurance company. It would be a big help. She has done all the things necessary on her end as has Dr. Andersons office but they still say they are reviewing her case. Needless to say, she has the flights all scheduled so to change the operation date would cost her. To make matters worse, she lost her husband on May 8th which has not helped her eyes. Her daughter who just got married this past weekend will be going with her to Utah.

I know this has been long winded as I usually get, but this wonderful lady could really use some help. Any info could be posted or sent to me and I would forward to her....Please keep her in your prayers also...Thanks...Alan




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Re: Help for a fellow patient.

Re : Help for a fellow patient. --- Alan Phair
Posted by Delaine Inman , May 23,2001,22:24 Top of Thread Archive
Wow Alan, I'm so glad she has you to speak for her on the BB. She is going through what no one should have to do and I am so sorry for her loss of her husband so recently on top of all of this. I don't have that insurance but I had to be persistent and keep making calls and finally someone from where I worked made some calls and got it all approved for me. It is very frustrating and my heart goes out to she and her family for having to deal with an insurance company at a time like this. I hope this can be resolved soon.



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Re: Help for a fellow patient.

Re : Help for a fellow patient. --- Alan Phair
Posted by Lori Howard , May 24,2001,01:13 Top of Thread Archive
Hi Alan,

Wow... It's been so long since I have been on the board (but that is a long and drawn out story and most who know me, know why). I can relate to Virginia in a sense. When I approached my insurance company (at the time it was BCBS in AZ, but can't remember who the administrator was) about having the surgery outside of AZ, I was denied. I then contacted the medical director who was involved in the decision. I had already had one myectomy here in AZ with absolutely no relief and this I explained to him. He said that there were many doctors in AZ that could do the surgery. My argument to him, and I kept the tone of my voice down, was that I could continue to have myectomy surgery in AZ with doctors that just don't do them that often and have a low success rate, or I could have it done by the doctor that essentially pioneered the myectomy surgery as we know it today and whom also sees hundreds of patients a year for this procedure with a high success rate. Now, I asked him, how many times do you want to pay for this? Two days later I received a call back from him stating that they would approve the Utah surgery. Strange, how they start thinking differently when you appeal to their pocket book.

Alan... please tell me you are going to make it to AZ this August????? It just wouldn't be the same without you. Take care everyone, and please know that even though I have been away from the board, you all have been in my heart and prayers....

Luv Ya'll.... Lori

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Re: Help for a fellow patient.

Re : Re: Help for a fellow patient. --- Lori Howard
Posted by Alan Phair , May 24,2001,07:57 Top of Thread Archive
Lori, thanks for the info and it is nice to hear from you again. Right now it does not look as though we will be making Arizona as I have a special party planned for my mothers 90th birthday at my house for about 150 people. The date was set before I knew the BEB date. I am trying to see if I can change it and right now, the only holdup are about twenty relatives coming to NH from CA. They are seeing if they can get their vacation dates changed. I told them I would pay for any airfare penalties. We will see.

Well, have to go. I am going in for surgery in a couple of hours and have to get to the hospital. I am having the screw removed from my heel that I broke last winter. It is starting to protrude thru the skin and is hurting. Now you know for sure that I have a screw loose....Alan




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Re:Just keep trying, Alan

Re : Re: Help for a fellow patient. --- Alan Phair
Posted by Shirley-Arkansas-USA , May 25,2001,14:43 Top of Thread Archive
Don't give up Alan. You know that the conference will be a bust if you don't go. Do you really want that on your shoulders?
Keep trying.

How did your surgery go? One loose screw is not so bad.

Shirley in AR.




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Re: Hey Lori!

Re : Re: Help for a fellow patient. --- Lori Howard
Posted by Delaine Inman , May 24,2001,20:12 Top of Thread Archive
Lori, it is so good to see you post again and "hear your voice". You have been in my heart and on my mind and I have missed you very much. I haven't been able to keep up with the BB like I did because I have been using my energy with other things. Bet you have been busy with AZ Convention. At first I was planning on coming. The main reason was to see friends I talk to on the BB. Some recent family things have made me reconsider my priorities and I may choose to visit my son Chris who is trying to close a deal on a Bed and Breakfast in Jefferson, TX. I want to help him move and see the place. He always comes from TX to TN to help us when we have moved and he came a few months ago to help my daughter move. So we owe him big time! My daughter Elisabeth and granddaughter Mikayla are living with us so that Elisabeth can go to nursing school and our life has really changed. She is going to try to go to both summer sessions of college and take 3 classes each time and work a few hours a week too. Mikayla will go to day care but I will still need to help out as much as I am able. It has brought a great deal of joy in our lives having them here. So I may pass on this year and see how things look next year.



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Re:Say it's not true

Re : Re: Hey Lori! --- Delaine Inman
Posted by Shirley-Arkansas-USA , May 25,2001,14:40 Top of Thread Archive
Hi Delaine,
I wish that you could do both things but I know that all this traveling is not cheap. You will be missed if you don't get to the conference. I know that you want to help your son out, too. You've been a busy bee these past weeks.

Shirley in AR. Missing Delaine's posts




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Re: Help for a fellow patient.

Re : Help for a fellow patient. --- Alan Phair
Posted by Shirley-Arkansas-USA , May 25,2001,14:34 Top of Thread Archive
Hi Virginia,
You've had a rough time. I'm so sorry about your husband. I know that Alan will help you in any way that he can. He's one of the good guys.
If you can get some help from your primary care doctor or whoever you see for your BEB or both, it might help. I'm not familiar with your insurance, so can't be of help there. Keep calling and ask to speak to someone on the review committee and explain your situation to them and that a decision has to be made and soon. If they need further information about BEB and functional blindness, you could possibly fax them some information. Try to find out what is holding things up so that those things can be addressed. Let them know that you only want to do this one time and DR. Anderson has the best reputation and has done close to a thousand myectomies. It may be being held up due to the cosmetic part of the surgery. Dr. A's office can help with that. Susan is really good with that. Some insurance companies still have botox listed under cosmetic procedures only. Just keep digging and pushing.
I know if your insurance does approve it, you will be pleased with Dr. Anderson and his staff. They are wonderful.
Good luck to you and have Alan let us know how things go.

Shirley in AR.




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