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mtn (Forum Supporter)
mtn (Forum Supporter) MegaDork
3/3/21 12:22 p.m.
barefootskater (Shaun) said:

I have a severe stenosis in my spine, causing issues with my arms and likely causing all these headaches too. I was scheduled to get some kind of injection to help relieve the swelling tomorrow. Except the insurance company won't approve it because it's "not medically necessary" so now I get to go back and see what my other options are. I've already talked to the doctor and my other option is to live with the issues and probably need neck surgery in a couple years. I'm 32. 
 

Insurance is a berkeleying ponzi scheme

 "Not medically necessary" defines what is inside or outside of your defined benefits. It doesn't actually pertain to what is necessary or not.

Ask your doctor to appeal the decision on your behalf. Alternatively, ask your doctor to ask for a peer to peer review.  Consider a new doctor if they're not fighting to get this for you, but there may only be so much they can do. 


Any chance that you could go into the ER, unable to walk, and get this injection as an Emergency measure? That may be a little bit unethical, but berkeley 'em. The insurance companies have made getting affordable care such a maze and luck of the draw that it takes a full time advocate to get anything done. the system is broken and you gotta look out for yourself. 

barefootskater (Shaun)
barefootskater (Shaun) UberDork
3/3/21 12:43 p.m.

In reply to mtn (Forum Supporter) :

That strikes me as a little over the line. I'm fully on board with "berk 'em" but I don't want to give the opposition any tools to use when it's time for my attorney to start talking with them about compensation. It's just a E36 M3ty situation to be in atm. Hurting and missing work but nothing anyone can do but play the insurance game. Once I'm back to "normal function" then the law folks get to have their talks and ideally make things right on my end, but I'm not holding my breath for any of that. 

Don't lie to my motherberkeleying face. Face your E36 M3,  you lying sack.

Rodan
Rodan Dork
3/3/21 3:23 p.m.

"In Stock" means it's on a shelf in your warehouse, awaiting the application of a shipping label.  It does NOT mean on a truck making its way to your warehouse... 

classicJackets (FS)
classicJackets (FS) Dork
3/3/21 4:14 p.m.

Found really nicely priced dis brakes for Riggamort 2 hours from home, the day my wife went into labor. The guy was cool with waiting, and today my wife and I made a trip out to Hillsdale, MI (boonies), because this morning he said today would work.

We made a family affair of it, "big"road trip with a 2week old, and he didn't reply to emails/calls with his address. CL ad said phone calls only but it goes straight to VM. We're making lemonade with a stop in a park and a dinner out, but still frustrated with myself for leaving without an address and him for stopping responding. Will be another 2hr trek sometime soon, I think - can't pass the parts up for the price.

Ashyukun (Robert)
Ashyukun (Robert) PowerDork
3/3/21 9:41 p.m.

In reply to barefootskater (Shaun) :

Definitely do try and get your doctor to resubmit it and fight for your getting it. When I snapped my Achilles' a ways back when the ortho doctor ordered a CAT/MRI (can't remember which) my insurance initially denied it and said it wasn't necessary- the doctor and the imaging place pushed back (yeah, doctor being able to see what he's getting into before cutting me open is a good thing...) and they eventually approved it. Had to wait around for a few hours we hadn't planned for at the imaging place, but that was about it. I think insurance companies initially deny everything remotely expensive in the hopes that you won't bother arguing about it and making them provide the services they're paid to provide.

barefootskater (Shaun)
barefootskater (Shaun) UberDork
3/3/21 9:54 p.m.

In reply to Ashyukun (Robert) :

We're pushing back. I see the doc again at 0700 and I already called the attorney too. They didn't deny the mri, but maybe they realized that mistake and decided to deny everything else. Just tired of this third party bs, and having to wait weeks for anything to happen while I'm in pain. 

Don49 (Forum Supporter)
Don49 (Forum Supporter) Dork
3/4/21 6:12 a.m.

I had stenosis at c4/c5 and the canal was narrowed to the point it was necessary to have surgery. Had a fusion and the canal opened up. Where is your stenosis? In my case, without the surgery I would have become a quadriplegic. 6 weeks out from the surgery the surgeon told me I could race the next day.

Scotty Con Queso
Scotty Con Queso SuperDork
3/4/21 6:29 a.m.
classicJackets (FS) said:

Found really nicely priced dis brakes for Riggamort 2 hours from home, the day my wife went into labor. The guy was cool with waiting, and today my wife and I made a trip out to Hillsdale, MI (boonies), because this morning he said today would work.

We made a family affair of it, "big"road trip with a 2week old, and he didn't reply to emails/calls with his address. CL ad said phone calls only but it goes straight to VM. We're making lemonade with a stop in a park and a dinner out, but still frustrated with myself for leaving without an address and him for stopping responding. Will be another 2hr trek sometime soon, I think - can't pass the parts up for the price.

I did this once. With my (3) kids and wife. Guy said he would text me his address the next morning. So we headed to his town after church. Instead of sending me his address he blocked my number, which I didn't realize until I arrived at his town. Oh well, we had a family lunch out and enjoyed our time together. 

barefootskater (Shaun)
barefootskater (Shaun) UberDork
3/4/21 7:21 a.m.

In reply to Don49 (Forum Supporter) :

C6/7

Placemotorsports
Placemotorsports GRM+ Memberand HalfDork
3/4/21 8:15 a.m.

Upstairs heat pump stopped working on Friday, had people come look at it Sunday and Tuesday and still not fixed.  Believed to be a bad defrost board so waiting on a part to try again Saturday.  Went to cook a couple burgers on the grill on Weds and the ignitor stopped working.  Wife sends me a text that the garage door won't open, had her send me some pics and the torsion spring broke.  This has not been a stellar week.

Ashyukun (Robert)
Ashyukun (Robert) PowerDork
3/4/21 8:26 a.m.

Finally had a rare convergence of free time and warm temperatures yesterdy to go out and try and make some progress on repairing the back fenderwells on the QX4. Spend like 1/3 of the time I had trying (unsuccessfully, so far) to find my 18V impact wrench to make taking the wheels off easier (would have been done quicker if I'd just said berk it and used the lug wrench from the start). Still cannot find the damn thing... at least this time I'm 99% certain that it's just misplaced somewhere around the house/garage and not left at a junkyard like the last one...

Also, still cannot post to the forums with Safari, am having to still use Firefox.

iansane
iansane Reader
3/4/21 11:22 a.m.
Rodan said:

"In Stock" means it's on a shelf in your warehouse, awaiting the application of a shipping label.  It does NOT mean on a truck making its way to your warehouse... 

I had one recently that was "in stock" because they had all the components to make it. As in, it was almost a month before it was shipped because they only built them after enough orders came in. They saw no issue with listing the part as in stock.

RevRico
RevRico UltimaDork
3/4/21 11:59 a.m.

For berkeleys sake, can I get one berkeleying break? Starting to feel like a berkeleying porcupine with all the thorns in my side

mtn (Forum Supporter)
mtn (Forum Supporter) MegaDork
3/4/21 1:28 p.m.

Holy Fark. Destination wedding, for someone I'd never imagine I'd skip their wedding. But I don't think I can afford this. Maybe if my brother and I split a room or if I'm able to stay somewhere off the resort, but... E36 M3. This is just stupid.

wae
wae UberDork
3/4/21 4:05 p.m.

On the way back in to the subdivision today the oil pressure gauge on the Excursion started bobbing up and down from normal to zero and back.  I hope it's just the sender - I don't really need to have two trucks that need engine rebuilds clogging up my workshop....

wae
wae UberDork
3/4/21 5:59 p.m.

Well.  It's not the sensor.  Sigh.

eastsideTim
eastsideTim PowerDork
3/4/21 6:24 p.m.
wae said:

Well.  It's not the sensor.  Sigh.

Oh crap, hope it was caught fast enough to not be too bad.

Mr_Asa
Mr_Asa UltraDork
3/4/21 6:36 p.m.
wae said:

On the way back in to the subdivision today the oil pressure gauge on the Excursion started bobbing up and down from normal to zero and back.  I hope it's just the sender - I don't really need to have two trucks that need engine rebuilds clogging up my workshop....

I know that my generation of Ford, the oil "sender" is actually just a switch that closes at about 6PSI, maybe they went back to actual senders for the later model stuff though

wae
wae UberDork
3/4/21 6:40 p.m.
Mr_Asa said:
wae said:

On the way back in to the subdivision today the oil pressure gauge on the Excursion started bobbing up and down from normal to zero and back.  I hope it's just the sender - I don't really need to have two trucks that need engine rebuilds clogging up my workshop....

I know that my generation of Ford, the oil "sender" is actually just a switch that closes at about 6PSI, maybe they went back to actual senders for the later model stuff though

No, the sender on this one is just a switch that's set to close somewhere between 5-7psi.  I put a real gauge on it, though, and I get 70psi on startup that drops back to 60psi and then drops down to 20 when I rev it a bit and to 0 when I rev it a lot.  Not cool.

chandler
chandler UltimaDork
3/4/21 6:43 p.m.
Rodan said:

"In Stock" means it's on a shelf in your warehouse, awaiting the application of a shipping label.  It does NOT mean on a truck making its way to your warehouse... 

I ordered the 4/4 drop kit from Belltech for my 89 Dakota because it said in stock. No. They make a few of them when someone orders one and they were currently out. All of their dealers showed them in stock but since no one actually stocks anything they were all wrong. 8 weeks later it arrived.

Duke
Duke MegaDork
3/4/21 7:19 p.m.
wae said:

Well.  It's not the sensor.  Sigh.

I've had cars that would do that if they were low or needed a change.

 

Wally (Forum Supporter)
Wally (Forum Supporter) MegaDork
3/4/21 7:26 p.m.

In reply to mtn (Forum Supporter) :

Considering how things are going right now I admire the balls it must take to do a destination wedding. 
 

 

mtn (Forum Supporter)
mtn (Forum Supporter) MegaDork
3/4/21 7:32 p.m.
Wally (Forum Supporter) said:

In reply to mtn (Forum Supporter) :

Considering how things are going right now I admire the balls it must take to do a destination wedding. 
 

 

Either balls, stupidity (although about 90% of the guest list is already vaccinated), or cowardice for being afraid to reduce the guest list to exclude extended family...

Streetwiseguy
Streetwiseguy MegaDork
3/4/21 7:34 p.m.
wae said:
Mr_Asa said:
wae said:

On the way back in to the subdivision today the oil pressure gauge on the Excursion started bobbing up and down from normal to zero and back.  I hope it's just the sender - I don't really need to have two trucks that need engine rebuilds clogging up my workshop....

I know that my generation of Ford, the oil "sender" is actually just a switch that closes at about 6PSI, maybe they went back to actual senders for the later model stuff though

No, the sender on this one is just a switch that's set to close somewhere between 5-7psi.  I put a real gauge on it, though, and I get 70psi on startup that drops back to 60psi and then drops down to 20 when I rev it a bit and to 0 when I rev it a lot.  Not cool.

You pulled the dipstick, right?

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