Ok.....still in limbo...but hopefully something will come about soon in my favor.

The actual appeal was postponed and rescheduled multiple times due to snow....then due to the lawyers actively working on a resolution and other factors. I have not yet officially presented my appeal. (I may not need to if the lawyers can settle the case) I did get my EOB's. I have a 60 day extention of the statute of limitations of the appeal deadline (which would have ended this month)

The Stanford Lawyer and the Insurance Company Lawyers are hacking out the details these last few weeks and hopefully it will be a positive ending. It is not a given...but I do feel optimistic.

Luckily, Stanford's lawyer said that the Insurance Co "DID" verbally agree prior to my surgery with Stanford to have an interum contract in my case and pay benefits of 80/20 ....then after the surgery they only paid as an "out of network" benefit of 60%. In the state of California, a verbal agreement between a provider and an insurance Co. is considered as solid as a written agreement, so they do need to step up to the plate. (they told me that as I had met all my co-pays, I would be covered 100%....well, we know what that meant....thanks very much)

So, I still wait and wonder what the final disposition will be. But, meanwhile a one week hospital stay in July (prior to going to Stanford) at the University Hosp in Cleveland seems to be considered as "out of network" and for that, I did not do any pre-negotiating as I was unaware of the situation altogether. So, I will have a considerable balance to work on locally when I finish the Stanford mess. An Ohio lawyer would be a good be a smart move for that headache. Hmmm....the only given here....is the Insurance Company and the lawyers....they always come out on top!

I think I need a chocolate fix.....

smiles....Diane : )

Diane,

I hope that the lawyers get everything workes out for you. Stay positive and keep us updated!

Christy

A received a phone call today from the Insurance Company representative that has been handling my case from the begining..........




I went from $261,000 to a zero balance.....what a stress relief!

They are now addressing the University Hospital claims in Cleveland which I spent a week as an inpatient with expensive diagnostics (that too, was considered as out-of-network benefits) I extimate that total to be around 50 - 60K.....but hopefully, we will end up with similar results.

So, I will thank God for all my endless blessings....and also enjoy a decadent box of lumpy, gooey chocolates "all to myself" !!!!

Diane  ;

thanks Lore!

I think this kind of stress relief........I can eat my way through an 18 wheeler!

Smiling on Chocolate Covered Cherries
Laughing popping goobers
Relaxing with Truffles
Cooling out on freshly dipped strawberries
In a corner, alone with an Almond Joy : )
Zoned out with a Reeses
I could go on....but it is making me have cravings!

GREG! I love how you put things in true perspective.

Yep....I kinda won $261,000 to use towards my overwhelming medical bills...and the best part of it is.....I don't have to pay any TAXES on those winnings!!!!!

We can also "scrap" the plans to live out of our car!!! Life is good.   

Hi Diane, I'm so glad that thing working out, that is a big celeration.  Get a 1/2 lb hersey chocolate and a cup of milk, enjoyce

Kieu