Friday, March 8, 2013

a response to my Appeal

I got home tonight about 9.30pm from my weekly business trip, with the feeling of having had a long week and really ready for it to end.  I pulled into the garage, grabbed my suitcase, pillows, unlocked the door and came inside the house.  I was locking the door to the garage when I thought to myself that I should go get the mail, but talked myself out of it because I just wanted to crawl in bed as I was flat out exhausted.  Then I remembered I had a full day scheduled for Saturday and I better just go do it now or it might be Monday before I got to it.  

After pulling out the mail from my locked mailbox slot, I flipped through the pieces and saw I had a piece from Humana, my Health Insurance Policy.  I honestly felt my heart skip a beat with anticipation as to the fact that I had correspondence from them, in all likelihood with regards to determination on the Appeal I sent to them.  I thought to myself, I am so tired and emotionally worn thin do I really want to read this tonight?  I thought about waiting until the next day, but decided to be calm and open it, knowing that whatever it said would have to be dealt with one way or another.  Either a third level appeal or potentially maybe some good news.  After a string of challenges, several disappointments, feeling devastated with the fight, discouraged with life, exhausted beyond words...I wasn't sure I was ready for any more news like I have had lately, but I wasn't sure I could put the letter aside and not open it until later, so I opted to open it.  The letter read "Here is the Decision on Your Inquiry" [This was a notice in response to my 2nd Level Appeal with regards to the denial to pay my surgery claims from my complete hysterectomy back on 10.09.2012.]  The letter stated "Our members are important to us, and we appreciate your patience while this was was investigated. [I am thinking, yah, yah, yah...normally blah blah stuff, let's get to the pertinent stuff.]  After a full and fair review of the information they have approved your request." [What?  They actually listened to me???  Dear God, Thank You!!!]  It went on to state "We approved coverage for services rendered to you on October 9, 2012, because of the additional information received with your appeal.  The information was sent to Humana's Medical Director who confirmed the service you received were not related to the Exclusionary Rider on your policy for endometriosis."  

Wow!  I truly  believed that God would work this out according to His plan, I trusted He knew what He was doing, but I honestly felt I probably was going to have to exhaust all options and complete all three levels of Appeals for me to get anywhere.  My deductible was completely met before I had surgery, which means I should have $0 out of pocket expense for this operation.  I knew that my patience, fervent prayers, my practical approach to the facts laid out in my Appeal, my bull dog approach (nickname given me by one of my clients which means stubbornly persistent), and my 17 years industry experience all were reasons that this ended up being ruled in my favor! This was some much needed good news during some really heavy times I have been facing!  

I am crawling in bed tonight with tears and gratitude that my God is with me!!! He has known my frustration... my feelings of being all alone...the impact of this financially...and He has been working a plan through all this. I never doubted Him...I simply have been VERY overwhelmed with the insurmountable amount of trials of late. No matter what happens next, I will still praise Him! He is MY God! And HE LOVES ME!!!

For those of you who have known about this issue and have prayed for me, fervently prayed for me and kept in touch with me on this situation to continue to pray on my behalf, I earnestly Thank You!  Knowing I have prayer warriors out there who share my burdens is a deep encouragement and I say Thank You!