Mary Teague
Junior Member
re: NEED LAWYER INS/DENIALS/MISMANAGEMENT/DAMAGES
What is the name of your state? Tennessee
History of my Health Condition and Insurance
Insurance - through employer
Full time employee
Illness - length of time - 54 monthes
Diagnois - Pudendal Nuerapathy/Nerve entrapment/Nerve damege
At the base of Spine and entrapment a ischial spine
Spent years going top local inwork Drs - 2002 - 2 special referal for pelvic floor specialist for Phyiscal Therapy
Only PT - out of network - insurance denies and I go to whle dr appeal and still insurance denies.
I am working still full during this time under pain scale
8/10 with ice belts I made for myself. Sitting some standing and working on my knees for 2 years.
Finally I find a Dr refers me to Mayo clinic and they send me to Houston Yexas for my diagnois I have now - Pudendal Neuraglia/nerve entrapment and I have nerve blocks to help find specic locations of entrapment and have surgery
This was 5 trips to Houston for me. During this time I appeal for insurance to cover out of network and this is the only location in the US at this time treating this rarity.
I received certification for surgery 1 day prior to surgery.
I layed flat for 2 monthes and wrote the Tennesse state insurance board regarding they covered the surgery but not the blocks. I raise money, borrowed from retirement, used son college fund to be able to get this protocal and proceedure, six monthes later the insurance wrote to Tennessee comm and state that I had been mishandled and they would be paying claims, for my recovery my physician ordered PT pelvic floor specialist and it took me 3 monthes to receive approval, which set my recovery back and
and they gave 5 visits and then a continual fight and stress while I try to recovery from a serious spinal injury.
In network - I can have 40 vists and at 30 they stopped paying and kept my appeals 30-60 day behind.
I had to increase my work from 3 - 4 -5 days to got to cash pay due to PT appeals and none payments. Now my Dr order these PT and I have backslide to not being able to work and Dr has sent employer that I can not work more than 3 days and looking at permenant disabilty if not able to take the dys for PT. I file bankraupty, lost credit, 55.000 filed, lost car, and have lost an incredable amount of recovery time. They never paid what they stated in letter or I would be receiving money back from where I paid and if I have my retirememt and college fund I have to spend I would be able to pay for and take time off from work to pursue disabilty I applied for and apparently the state lost my file I have just found out - I was denied but they can not locate my file to tell me why. So there is another case I have to pursue. I need help. Single mom and son, on the verge of losing home at this time. They want to wear me down to quiting my job so they won't have to deal with me anymore. I fought so hard to get this far. My son has suffers now from Gerds due to stress, and I have neroplasity that has to change from long term pain endured and dealing with insurance I can not have the
changes in body take place. I do have a Dr that will stand behind my case, severity that the stress and neglecaince of having PT the bases of my recovery.
Anyone of there to take on this difficult case
Mary
What is the name of your state? Tennessee
History of my Health Condition and Insurance
Insurance - through employer
Full time employee
Illness - length of time - 54 monthes
Diagnois - Pudendal Nuerapathy/Nerve entrapment/Nerve damege
At the base of Spine and entrapment a ischial spine
Spent years going top local inwork Drs - 2002 - 2 special referal for pelvic floor specialist for Phyiscal Therapy
Only PT - out of network - insurance denies and I go to whle dr appeal and still insurance denies.
I am working still full during this time under pain scale
8/10 with ice belts I made for myself. Sitting some standing and working on my knees for 2 years.
Finally I find a Dr refers me to Mayo clinic and they send me to Houston Yexas for my diagnois I have now - Pudendal Neuraglia/nerve entrapment and I have nerve blocks to help find specic locations of entrapment and have surgery
This was 5 trips to Houston for me. During this time I appeal for insurance to cover out of network and this is the only location in the US at this time treating this rarity.
I received certification for surgery 1 day prior to surgery.
I layed flat for 2 monthes and wrote the Tennesse state insurance board regarding they covered the surgery but not the blocks. I raise money, borrowed from retirement, used son college fund to be able to get this protocal and proceedure, six monthes later the insurance wrote to Tennessee comm and state that I had been mishandled and they would be paying claims, for my recovery my physician ordered PT pelvic floor specialist and it took me 3 monthes to receive approval, which set my recovery back and
and they gave 5 visits and then a continual fight and stress while I try to recovery from a serious spinal injury.
In network - I can have 40 vists and at 30 they stopped paying and kept my appeals 30-60 day behind.
I had to increase my work from 3 - 4 -5 days to got to cash pay due to PT appeals and none payments. Now my Dr order these PT and I have backslide to not being able to work and Dr has sent employer that I can not work more than 3 days and looking at permenant disabilty if not able to take the dys for PT. I file bankraupty, lost credit, 55.000 filed, lost car, and have lost an incredable amount of recovery time. They never paid what they stated in letter or I would be receiving money back from where I paid and if I have my retirememt and college fund I have to spend I would be able to pay for and take time off from work to pursue disabilty I applied for and apparently the state lost my file I have just found out - I was denied but they can not locate my file to tell me why. So there is another case I have to pursue. I need help. Single mom and son, on the verge of losing home at this time. They want to wear me down to quiting my job so they won't have to deal with me anymore. I fought so hard to get this far. My son has suffers now from Gerds due to stress, and I have neroplasity that has to change from long term pain endured and dealing with insurance I can not have the
changes in body take place. I do have a Dr that will stand behind my case, severity that the stress and neglecaince of having PT the bases of my recovery.
Anyone of there to take on this difficult case
Mary