Friend wanting to have WLS denied by Ins.

Hello everyone!!! I would like all of those who had WLS surgery and were denied once, twice, or more by their insurance company what avenues did you have go down and what procedures did you and your PCP have to go through in order for you to be finally approved for your surgery. I have a friend that wants to have the surgery but she is not getting much support from her PCP and also her insurance has denied her once. What should she do????

I too went through being denied twice. It was such a depressing time for me. I not only had a physician who did not wholeheartedly support me but also several insurance companies that were very difficult to deal with. I took my case to appeals and found it to be of no good. I wrote several very educated letters for presentation at my appeals case that did not help either. Finally, on my third and final attempt, I succeeded! I changed to a physician who was very supportive and made sure his documentation was exactly what the insurance company was looking for and I also changed to Blue Cross Insurance Company. The two keys you must have is the support of your PCP and insurance company. Diana

I contacted the insurance director of my company and told him of my journey and asked him to help me. I also wrote a very personal letter describing how I felt daily and what this surgery could do for me and I included a picture of myself. With that and the Ins. director going to bat for me I was approved on the first appeal... just tell her to never give up. Those are people just working the system and pushing paper and this is her life that she is fighting for... there isn't anything more important.