Re: INFORMATION ABOUT THE CEC IN ATLANTA!!!
From: anonymous (anonymous@obgyn.net)
Thu Sep 7 11:55:41 2006
Ladies, this is why it is so important that we keep daily journals that
track our symptoms AND the effect this has on our lives. Our
relationships, careers and education are all deeply affected by chronic
illness and endometriosis is one of the most destructive in terms of the
emotional toll it takes.
I had cancer and needed a hysterectomy (all other treatments had failed)
but because I was under a certain age my insurance company had the
audacity to DENY me a life-saving operation!!!! IN THE USA!!!! I finally
did get the surgery I needed but it wasn't until the scheduling nurse
read my journal to an account supervisor that I was "ALLOWED" to have
the MEDICAL PROCEDURE that my EDUCATED and TRAINED DOCTOR determined I
needed. When my doctor gave me the post-surgical report and I realized
that some pencil-necked, calculator tapping moron was practicing
medicine without a license and actually may have caused my premature
death I was incensed - but as long as the insurance companies are
allowed to dictate what constitutes as healthcare in this once great
nation, people will continue to die of curable diseases.
DOCUMENT EVERYTHING! It may make all the difference.
Stay strong - you are your own best advocate.
At Wed, 6 Sep 2006, PAMELA wrote:
>
>Just some info on the CEC from my experience,
>
>I too am in the process of having surgery with Dr. Sinervo at the CEC
>in Atlanta. I am still in the process of sending my medical records to
>them to schedule a consult & hopefully excision surgery before the end
>of the year. I have been in touch quite a bit with Heather & Muriel
>there & they are extremely nice. I guess I am lucky because my
>insurance (United PPO) is in-network with the hospital but
>out-of-network with Dr. Sinervo & Dr. Albee. I have done quite a bit
>of research on the internet & I have found that if that is the case your
>insurance could actually turn tables on you & make the hospital where
>the surgery is being done out-of-network too if they want to if the
>doctor is out-of-network with them (even if you set up an agreement to
>pay the doctor on the side since he is the only one out-of-network). So,
>after working with Heather & Muriel at the CEC I am in the process of
>trying to get a referral from my primary care doctor here in Florida for
>Dr. Sinervo. I was told that my PCP needs to write a letter to my
>insurance explaining that there are no surgeons in my area that do
>excision surgery & send to my insurance & with that I can get a referral
>or authorization from my insurance to have both the doctor & surgery
>covered as in-network. Of course, I might have to get involved too. I
>am working on this right now, so if anyone wants to know actually what
>happens I will let them know. Just let me know. Now, the CEC told me
>that if this is out-of-network (that is provided you have insurance) you
>have to pay your deductible up front along with approx half of your out
>of pocket. But, I am sure that they will work with you. They seem very
>nice & helpful there (at least everyone that I have spoke with lately).
>
>Thanks,
>Pamela
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