Pool_1

"You see? That's it! They wouldn't let me use Jimmy. For the last twenty years he never once messed, well that drop lock, but he fixed it immediately. No questions!" "Elaine, here in your chart, that's the copy of the prescription. That's eighteen months ago." "Look at what I'm wearing. I'm embarrassed to lift my skirt, no, not my legs, look, duct tape! Twist ties and tape are holding me up. Actually I'm killing my arms. I think I did something to my rotator cuff." The doctor gasped, "Jeez, don't mess up those arms." Elaine was no dummy. She brought the brace back to the "provider" whose shop was a house with no machinery, no tools in view, just a pot of cabbage on the stove. "Cabbage?" "Cabbage. Trust me. I know cabbage. Oh, he isn't listed in any directory of certified orthotists." And, yes, she had appealed. As a medical social worker, she knew exactly the drill and did it all, all documented to the finest detail, for all the good that did. She showed the doctor her fourth and last appeal denial which stated that AmeriMed had contracted the said services to a provider of services in accord with restrictions as pertain thereto in contract appendix XXIXX as appended without notice pursuant to change in availability of services as deemed appropriate by the insurer. The insurer was, by contractual language, responsible neither for the art nor condition of the goods provided, but only that goods were, in fact, provided. Having so assigned a provider of services, the terms of contractual obligation were fulfilled. Shannon had done her bit and had gone not only to the insurance commissioner, who as always, had a convoluted way of saying that this particular issue was not in his jurisdiction, not that any are in that payola no show job. Shannon went to two county freeholders and to the public watch dog Citizen Trust, three newspapers, and the

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