Teresa sent a message to Joseph R. Swedish – President and Chief Executive Officer of Anthem, Inc. Email Address that said:
I would like to let you know the issues I am having with Anthem. a request for surgery authorization was denied and a peer-to-peer was done on 7/27/16 with Dr. Gopinath (anthems dr). He stated that anthem should approve if the device used was changed to one covered by my insurance. This request was sent for approval and denied for same reason. It appears that the peer-to-peer notes were not considered before denying a second time. After multiple calls to anthem by me and my Drs office, with promises of call backs which NEVER came, and promised response times, which NEVER came on time. I am told now I have to deal with DMHC myself, which I have filed that complaint form. Meanwhile I am in pain and not able to get the surgery that my doctor assures is 90% certain to help my pain. I was told that my insurance would cover a fusion surgery, which my doctor says because of my age (58) and active life style (which I am unable to do because of the pain) would not be in my best interest, the disc replacement is the better option for me. This has been a very trying experience dealing with all of the hours of phone calls we have made and lack of response from Anthem. this process has only added to my lack of quality of life due to the stress involved. I would appreciate if you could look into this matter as soon as possible. Thank you Teresa
