Appeal Letter
Dear Appeals Coordinator:
I wish to appeal your decision to
deny payment for the acupuncture therapy I have been receiving. I have
already tried the traditional medical treatments provided at your
facility and they have been totally ineffective. In contrast, the
acupuncture treatments have been extremely helpful.
With the onset of pre-menopause in
about 1998, I have been suffering from migraine headaches. With every
year, they have become more frequent and more severe. Several days I
have had to stay home from work because the pain has been debilitating.
These headaches have lasted as long as 2-3 weeks. I have sought medical
treatment at Group Health, and have been
prescribed high doses of Ibuprofin,
Excedrin, and Maxalt MLT. These are painkillers that only make the
headaches more tolerable, but do not prevent their occurrence. If I am
not quick enough to recognize the onset of the migraine, I am
paralyzed with pain. Neither my physician nor I feel it's healthy to
keep taking these drugs indefinitely, but this is the only treatment
that Group Health seems to recognize.
A second affliction of my pre-menopause has been
my
inability to sleep at night. This often leads to headaches the
following day. My physician prescribed Trazadone to help me sleep. In
the last six months, I have gone from taking 1/2 pill to 2 pills every
night, and I still have occasional difficulty sleeping.
On April 6, I visited Michelle Wu, a Chinese acupuncturist. I described
my problems with migraines and my difficulties with sleeping, and she
told me she could help with just 2 visits per week the first two weeks,
and thereafter weekly visits for a few months. Eventually, two
treatments per month should do the trick. I have had six treatments
from Ms. Wu. Group Health paid for the first five,
but now refuses to
pay for any further treatments.
Since my acupuncture treatments, my quality of life has improved 100%.
I have only suffered one headache, and it was of short
duration and not severe. I have been able to sleep at night without
taking the pills that were prescribed at Group Health. I no longer live
in fear of incurring a headache if I exercise, eat the “wrong” food,
get stressed, or get-over tired. Friends have told me that my face
looks
so much healthier, and I attribute that to the fact that I am no longer
taking the medications.
I encourage you to reconsider your decision not to pay for my
acupuncture treatments. I think it will save you money in the long run,
since they have made me healthy and not a chronic patients of yours. I
know you must base your decision on costs and proven benefits, and you
are probably suspicious of acupuncture. I was a big doubter as well,
but I was desperate to find something that works. I am convinced that
this treatment has been working for me, and if you are really serious
in your commitment to providing the best medical care for your
subscribers, you will agree to pay for these costs.
Thank you for your consideration.
Anonymous
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