Need #7: Insurance Companies Should be required To Explicitly List Non-covered Treatments
Right after the holidays our appeal came up. My attorney, our company H.R. director, and I all went to the hearing. The insurance company had 2 people that were just HMO members, their President, their medical services director, and a consulting doctor. They also had a doctor from their holding company on the phone.
Their consultant pulled out a bunch of articles from medical journals about ABMTs. I was confused. Although the articles said they were unproven, the articles were several years old. Medical technology changes so much I couldn't believe that they used such old stuff to back up their contention that ABMTs were experimental. In my job with computers, if I ever based a recommendation on information 3 or more years old I would lose my job. At any rate, the deck seemed stacked against me. Even if after hearing my more down to earth explanation of the treatment, the two regular members of the HMO were swayed, there were still three HMO employees there to vote against me. I was really annoyed. It seemed like such a farce. At any rate my attorney said that as soon as we got a letter from the HMO we could proceed with the suit as he didn't think they would vote my way either.