Re: Thanks, everybody! Re: WE WON (Actiq)

On Wed, 26 Sep 2007 18:50:15 GMT, "cllmd" <cllmd@xxxxxxxxxxx> wrote:

Thank you, everybody, for your good wishes and for sharing my joy! Kinda
feels like we all win when one of us breaks thru the medical/insurance/govt
system, doesn't it?

This was the last hope, shy of starting a lawsuit, the CA State Insurance
Commission. They actually farm it out to group of doctors. These docs are
paid by the STATE, not the insurances or pharmaceutical companies. The top
neuro on my case wrote an interesting statement at the end. It's about a
page long. I'll type it up and post it when i get a chance....it's
informative.

But my HI bud Wayne brought up a truth. chris and i are not completely
convinced until those boxes show up on my porch, or we get them at the
pharmacy....haven't spoken with the insurance to find out how i'm to go
about getting them. If i hafta get them from the insurance, it's 3 mths
supply. (cool thing about that would be that, if it's the 3 month thing,
then i'll have the sucker supply to get me thru December and the holidays.)
Although we are thrilled the state has come thru, the history of this
insurance company makes us sure that they will pull some other trick. I'm
more than willing to get the suckers thru them, and to go with the generic,
which i've had and there seems to be zero difference.

The heat makes my head pain much, much worse. We usually are in the 90's
thru Sept and upper 80's thru October. This year we've had a cool stretch
already. That has been a major blessing.

However....i don't trust stuff going too right. Something always comes
along when the cards are coming up in our favor. There's a shoe due to
drop...

But in the meantime, YEA!!!!!

WHEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE!!!!!!!!!!!!!!!!!!




"Hawaiian Wayne" <birdie998@xxxxxxxxxxx> wrote in message
news:1190799631.201894.122180@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
On Sep 25, 6:14 pm, Top <t...@xxxxxxxxxx> wrote:
On Tue, 25 Sep 2007 16:55:40 -0700, cllmd wrote:
The suckers aren't at the door yet, but the paperwork came thru in our
favor.....the arbitration was binding, and they found that the
insurance
must pay for the suckers.

more later......

thank you for putting up with me!
Lavon

GREAT!! I happy for you!
Top

Aloha Lavon!

Man. I can't tell you how nice it is to come back to this site after a
fairly long (for me!) absence because my monitor died on me and I had
to order a new one (It just came today), only to see this VICTORY POST
on the same day!

Obviously this Actiq works so well for you that it gave you the
strength and determination to fight for your right to have it. That's
usually the only motivation I need to 'fight' through the system
that's set up and WIN. I loosely use that phrase "the system" as it's
more like the "games" the insurance companies play thinking we are too
weak to fight and will just "drop it" eventually, and without a
decision. Hey, if I find a medication that really works for me and my
insurance company refuses to pay for it and there is no other
alternative...I've done the same thing. funny thing is, and I don't
know if you found this to be true also, but did you have to "keep on
your doctors back" in order to get him/her to keep up 'the fight'?
Again, if so, it's all part of "The Game".

Doncha t'ink? Or doncha? CONGRATULATIONS! (Is there a small part of
you that is still holding off the "celebrating" until you "see it to
believe it"?)

I have a few topics I'd love to start threads on that I've said I'd
post and even newer ones that have come up recently that I've STILL
NOT posted! I hope by tomorrow I find the energy.

(One of my threads will explain why I have NO energy right now.)

Aloha For Now,
Hawaiian Wayne



I won a small victory about a year ago: The right to get more epidural
steroid injections. The insurance company did throw a wrench into the
works. Your next hurdle will be to overcome the quantity restriction
imposed by your insurance company unless that was also a part of your
appeal.

I really am interested in hearing just how you did this especially
since it looks like you are in CA.

I does feel good though to win doesn't it.

Mike
.

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