More on insurance...

Sorry, but I need to complain again about insurance. This has been a huge deal in my life for months now and they just continue to frustrate me. You see, their own document on appeals says

The appeals committee will notify you in writing of the decision within the following timeframe: Pre Service Claims (services that have not been obtained) - 15 days from receipt of your appeal

yet it seems to me the only time they care about their own timeframes is when I miss it. You see, I received their letter dated 9 May telling me they had my appeal in their hands and reiterating what the manual stated about 15 days for a decision. Nothing came, nothing came and so I asked my HR person at Novell to help out. That was when Altius finally called me on Monday of this week to tell me they were working on my appeal and they might have a decision by Friday. I asked them about the 15 days but the question was blown off. She then verified my number so she could call me on Friday and let me know the decision and I made sure she had my cell phone as well. That takes us to Friday at 1625 when I had not heard a thing from them. So I called Altius only to find out they denied my latest appeal. So it took them almost a month to come back and deny the procedure all the doctors working on me suggest. It's incredibly frustrating because they don't have to live with this roller-coaster ride of hope and despair. So my next move is another appeal. This one I am allowed to show up in person for and I'm wondering if I need to invest in an attorney for this next appeal. It's $15k to trial the procedure the doctors want to use on me so I'm thinking it would be worth it to invest a bit in an attorney if needed. If they deny the next appeal my only hope is for an external review, but Altius only uses those when it is deemed medically necessary and I'm sure their first move will be to say the procedure is not necessary so I'll have to fight that before I can get the external review. Stay tuned, the battle may have been lost but the war continues!