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Tennessee Freeping Help Needed {Tenn Care}
self | August 1, 2002 | cva66snipe

Posted on 08/01/2002 1:12:11 PM PDT by cva66snipe

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To: unsycophant
Ok I have a letter of first denial dated 5/21/02 I have a letter of acknowledgement of recieving our appeal date 5/30/02. It was over the phone to try and rush it up some. That and the fact I have trouble myself keeping this stuff straight and they know it. I'm not parinoid they have my medical records and know this fact about me through having that info on my medical records. That is part of my disability. It's sensory triggered Anxiety Disorder and concentration is a cherished commidity these days. Stress worsens the condition rapidly. They use it.

They act as if they do not have the appeal or will not consider it. I can't get a deffinate on that but I do have their acknowledgement one was filed. And I did request an Admin judge hearing.

When I ask to check the status they simply say Tenn Care does not pay for extractions. I have asked for further appeal and was told to call Medicare. I had to let it drop then and go another route for my sanity sake. That was earlier today. I know from past experience and shouting matches with them it's gets me nowhere. They even went as far one time as to give me the lawyers name in Nashville I can't remember it from the advocates office and laughed doing so.

I've tried Senator McNally before several times it was a joke all he got me was a phone call from the same ones who gave me telephone roulette. My Rep is a freshman a good one I will loose due to redistricting. I'm in a traditional Dem district now.

Unless you've fought this mess your self I guess it's hard to understand. They have no respect for you or even their own rules. And by the grace of congress they know they are exempt from any liability in the matter. It's an arrogance that would rival the Kennedy's and Clinton's. I'll try the route you mentioned tomorrow. I'm famuliar with it. Thanks

21 posted on 08/01/2002 11:15:23 PM PDT by cva66snipe
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To: cva66snipe
Does your area have a local radio talk show host? How about getting with him/her on this? I know you might not want the publicity, but this nonsense has to be stopped and exposed.
22 posted on 08/02/2002 5:28:01 AM PDT by GailA
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To: GailA
Yea we got Halarin {sp} Hill he's pretty good on things like this. I made some calls today One was to Tn Care Solutions who told me yesterday that it was medicares domain today tells me Medicare doesn't cover it. Tennessee Justice Center called me after I e-mailed them last night. It is Tenn Cares domain if we can prove medical necessity. A simple smile would say it all I think any person seeing her teeth would say as much doctor or no. It makes mine hurt seeing them. I'm going to let Tn Care Advac. see what they can do we may know something perhaps this afternoon likely Monday.

My last go arounds with Tenn Care was writting letters which no one could read due to my lousy hand writting. Computers make all the difference in getting needed info fast and for me is a valueable tool. My family got it for me a few years back and it has paid for itself several times over giving me quick valuable medical info. One example was she was hospitalized in January of this year and doctors were not locating the cause. She was having very out of character almost psychotic episodes. To get her ready for this extraction we sought some help getting her through the anxiety. 12 years ago a Knoxville Dentist nearly killed her. The dentist later on did kill a girl in his treatment room from improper medications.

To get her over this hurdle she was given anti-depressants. She developed what is called Serotonin Syndrome in January and went Comatose in the hospital Emergency Room. treatment was refused while we waited on Mobile Crisis. I took her in that state to another what I thought was more skilled hospital. The got her back around but after 5 days no diagnoses. She was detoxed from all medications including heart and started improving. At that time a shrink put her back on SSRI's andwithin two hours the episodes returned.

Prayers were said and quickly answered. I went home got on line and typed her last two medications the SSRI's +adverse reactions and got the Serotonin info. It saved her life. I had a debate with the doctors at the hospital none of whom was her primary care personal physican but house doctors and convinced them simply because it was a UT pharmacolgy professors alert. She's been through a lot and this left some scars for her to deal with as well as myself.

The doctors said Mobile Crisis had to act on her behalf. The doctors rather than doing simple and telling blood work were too interested in doing a patient dump to a place not equiped to take her. My biggest fear is seperation from her. Not like going fishing or something but government stepping in and trying to think for us. That night was a nightmare come true. It set us both back and has made me rather cynical toward the conditions that brought things to that point. 10 years ago this would not have happened. Tenn Care has ruined health care in this state.

23 posted on 08/02/2002 12:20:01 PM PDT by cva66snipe
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To: cva66snipe
Keep us updated as to what is going on. get Halarin Hill back on the case. This has to be stopped. I sent your post to Steve Gill, hopefully he will help. Get on to your local TV news anchors about this, there is usually one of those ON YOUR SIDE reporters looking for some one like you to bring to their viewers. Prayers again.
24 posted on 08/03/2002 5:34:26 AM PDT by GailA
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To: unsycophant; GailA; JDGreen123
Here's where we stand as of today. I just got off the phone with the Tenn Care Advocate Office. It seems her appeal paper work was forwarded to the Office of General Councel sometime in early June and promptly lost along the way. The TCA said that due to the extended time delays already involved because of this they are going to try and get the go ahead and grant the approval A.S.A.P. foregoing a hearing before a judge which would mean help is on the way sooner than we thought. We should know something as early as late this afternoon or in the next few days. Thanks again.
25 posted on 08/14/2002 9:40:33 AM PDT by cva66snipe
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To: cva66snipe
That is good news. I hope they let you know something very soon. Thank you for the update. Fingers crossed that they will give you approval!
26 posted on 08/14/2002 10:08:16 AM PDT by unsycophant
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To: cva66snipe
Great! Let us know if we can help in any other way!
27 posted on 08/14/2002 11:26:36 AM PDT by JDGreen123
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To: Admin Moderator; Sidebar Moderator
Please remove post #2 for privacy & security reasons it has served it's purpose long enough. Thanks
28 posted on 08/23/2002 6:42:58 PM PDT by cva66snipe
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To: Jim Robinson; GailA; TomServo; unsycophant; pubmom; backhoe; JDGreen123
Update: She is half way through her teeth extraction's and doing fine. It's being done in the office under a surgeons close watch. Now for the latest. WE WON!!!!!! The surgeons office called a few minutes ago and said Tenn Care had notified them it was approved and what had been paid so far by us would be re-paid back to us.

Those letter that were written and phone calls that were made for her is what did it. I deeply appreciate the efforts that was made for her. I don't think this would have happened otherwise. It took 3 months but they were made accountable. This came out of the blue as we had done been told by the advocacy office a few weeks ago more or less to forget it. Help wasn't coming. The approval came to them from some higher ups who can on their word do something about it.

The doctors office let it be known as well just how serious it had became while they dragged their feet. There was never a question of medical necessity but rather a race of getting infected teeth out before her throat swelled shut. That danger is now past as the worst ones are gone and the lower teeth are next starting in November.

I still oppose those of our elected who support this type of abuse of taxpayer money that support Universal Health Care. I honestly don't care what parties name they hold to I will vote them out on this issue. As citizens of Tennessee we know this issue is also a direct cause of the Income Tax fight so actually it covers many issues stemming from a single cause.

JimRob Thanks for letting me post this thread. It did make a difference. I have been fighting this insane program for over 10 years trying to see it's defeat. Unfortunately the GOP has been amongst the worst shills of supporting it as far as my state goes. I would say the pollster who called my house today got a weird reply. I was asked if I would support Van Hilleary-R for governor as well as my current state senator Randy McNally-R in November. I said yes to the first one and I said I would never vote for McNally again for anything. If nothing else I will leave the ballot space for him blank.

Universal Health Care needs to be stopped and none who support it should ever get our vote no indeed not at any price. No not even for the sake of a majority seating. Tennessee holds a good political lesson in that respect for those willing to learn from it. RINO's are not worth the effort of flipping the ballot marker to vote for them and are extremely destructive to any hopes of restoring accountability in government. They serve only as dividers to that cause and on issues such as this will stand with the DEM's. But then again some DEM's as well will fight the good fight too.

29 posted on 10/25/2002 4:02:01 PM PDT by cva66snipe
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To: Jim Robinson; GailA; TomServo; unsycophant; pubmom; backhoe; JDGreen123
Update: She is half way through her teeth extraction's and doing fine. It's being done in the office under a surgeons close watch. Now for the latest. WE WON!!!!!! The surgeons office called a few minutes ago and said Tenn Care had notified them it was approved and what had been paid so far by us would be re-paid back to us.

Those letter that were written and phone calls that were made for her is what did it. I deeply appreciate the efforts that was made for her. I don't think this would have happened otherwise. It took 3 months but they were made accountable. This came out of the blue as we had done been told by the advocacy office a few weeks ago more or less to forget it. Help wasn't coming. The approval came to them from some higher ups who can on their word do something about it.

The doctors office let it be known as well just how serious it had became while they dragged their feet. There was never a question of medical necessity but rather a race of getting infected teeth out before her throat swelled shut. That danger is now past as the worst ones are gone and the lower teeth are next starting in November.

I still oppose those of our elected who support this type of abuse of taxpayer money that support Universal Health Care. I honestly don't care what parties name they hold to I will vote them out on this issue. As citizens of Tennessee we know this issue is also a direct cause of the Income Tax fight so actually it covers many issues stemming from a single cause.

JimRob Thanks for letting me post this thread. It did make a difference. I have been fighting this insane program for over 10 years trying to see it's defeat. Unfortunately the GOP has been amongst the worst shills of supporting it as far as my state goes. I would say the pollster who called my house today got a weird reply. I was asked if I would support Van Hilleary-R for governor as well as my current state senator Randy McNally-R in November. I said yes to the first one and I said I would never vote for McNally again for anything. If nothing else I will leave the ballot space for him blank.

Universal Health Care needs to be stopped and none who support it should ever get our vote no indeed not at any price. No not even for the sake of a majority seating. Tennessee holds a good political lesson in that respect for those willing to learn from it. RINO's are not worth the effort of flipping the ballot marker to vote for them and are extremely destructive to any hopes of restoring accountability in government. They serve only as dividers to that cause and on issues such as this will stand with the DEM's. But then again some DEM's as well will fight the good fight too.

30 posted on 10/25/2002 4:04:36 PM PDT by cva66snipe
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To: cva66snipe
Thanks for telling me, and I am pleased your situation has improved. Aside from the misery they cause, abcessed teeth can be very dangerous. My late first wife was C-5 quad; I've walked down that road- may God bless you both.
31 posted on 10/25/2002 5:32:41 PM PDT by backhoe
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To: cva66snipe
This is GREAT news. It's about time too. Nothing like embarassing some public official into doing the "right" thing.

When I voted Monday I left Rep Bubba Pleasant's box unchecked..it didn't matter much as he is unopposed. He voted for the tax hike.

32 posted on 10/25/2002 6:25:30 PM PDT by GailA
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To: cva66snipe
Glad to hear the good guys won one for once. Hope you both can relax and rest a bit now. I tell you I am getting to the point of respecting a flaming liberal more than a RINO. At least you know where you stand with a far-lefty. RINOs are the ultimate straws in the wind. It concerns me that so many East Tennessee Republicans now seem to be RINOs. I never cared much for Howard Baker, another RINO in my opinion. It seems that many East Tennessee Republicans pattern themselves after Baker and drift further left from there.
33 posted on 10/25/2002 11:20:32 PM PDT by JDGreen123
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To: cva66snipe
Great News!!
34 posted on 10/26/2002 9:21:23 AM PDT by TomServo
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