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Question about a denial letter

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Posted by Matthew L. on June 24, 2009 at 12:28:23:

I'm writing this on my mothers behalf. Shes rather upset about a letter she got today, so I thought Id look into for her. She has cobra in which her 18 months runs on in November of this year. She has been having issues w/ her knee that she has had to get shots every 3 months just so she can walk on it.

Recently it's been so bad; the last shots she received did nothing. Her Dr. wanted to perform a MRI since she was in so much pain. After doing the MRI, they saw that her knee is bone-to-bone on the inside of her knee but the outside was OK.

He advised to her the only treatment for this would be to have a partial knee replacement. He went ahead and booked her surgery for the end of next month.

The letter she got today from Cobra is stating they are denying the surgery because there are "other treatment options", and that she can try to apply again on December 2009 which is crazy since hers runs out in November. Even her Dr. advised this would be the only option to resolve this issue since it is officially bone-to-bone now.

Does anyone have any advice as to what steps she needs to take now?

Thank You

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Subject: Re: Question about a denial letter

Comments:
: I'm writing this on my mothers behalf. Shes rather upset about a letter she got today, so I thought Id look into for her. She has cobra in which her 18 months runs on in November of this year. She has been having issues w/ her knee that she has had to get shots every 3 months just so she can walk on it. : Recently it's been so bad; the last shots she received did nothing. Her Dr. wanted to perform a MRI since she was in so much pain. After doing the MRI, they saw that her knee is bone-to-bone on the inside of her knee but the outside was OK. : He advised to her the only treatment for this would be to have a partial knee replacement. He went ahead and booked her surgery for the end of next month. : The letter she got today from Cobra is stating they are denying the surgery because there are "other treatment options", and that she can try to apply again on December 2009 which is crazy since hers runs out in November. Even her Dr. advised this would be the only option to resolve this issue since it is officially bone-to-bone now. : Does anyone have any advice as to what steps she needs to take now? : Thank You

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