I got denied again....................

Well, I got good news this morning and bad news this afternoon.
They denied me again for my WLS......
Now they say I didn't have an exercise program or something like that.....  I can't remember now how they worded it.
The Surgeon's office said that even the gal that she spoke with at BCBSIL was shocked.  I had 127 pages of documentation that was faxed.  I gave them copies of my CURVES documentation, also being councelled on exercise from the Heart Smart program that I am enrolled in.  I told them I owned a treadmill, giselle, total gym, Urban Rebounder, Stationery Bike and various DVD's of exercise programs.
Can I just scream, WTF????  Ugh!!!
I'm feeling pretty defeated right now..........
I do have a call into an attorney that Janine suggested, and I am also going to find out if the Surgeon's office is going to "fight" for me or not.  Maybe I need a new surgeon.........  I don't know, I'm just angry and hurt.   UGH!!!

WTF?!?!?!?!?!

DO NOT GIVE UP! You so deserve to have this, you have worked your tail off, I cannot believe they denied you!

Definitely find out exactly what their reasoning is and then fight fight fight! We are all behind you!


Shells

I'm so sorry you are going through this, but I know you will not give up, and soon you will prevail!

 Have you grieved your case with the California Department of Managed Health Care?  I have Kaiser and they do not do the DS so I requested to be referred to Dr. Rabkin in S.F.  Kaiser denied me twice so I submitted a request to the DMHC and asked for an Independent Medical Review (IMR).  Today I got the news that they found in my favor.  Kaiser has to refer me to Dr. Rabkin and they have to pay.

It is soooo worth the fight.

 I am so sorry.  I get so angry when I hear about denials.  Who in the he-- do they think they are messing with peoples lives that way.  I am so truly sorry that you are going thru all of this.

Best of luck to you.  I hope the attorney calls you soon.


Linda

That is just crazy, I am so sorry to hear that.  Don't give up, you have worked way to hard for this and you deserve it.  We are with you and will do all that we can to help.

Hang in there. Today just absorb the good news on the biopsy. Tomorrow, find out what you need to do now. I know you are determined to win with this and you will.

Take care ~ Lori

Jeni, I don't know what these people are thinking. You so deserve to have this surgery. Don't give up the fight hun. Persevere and it will happen. Remember, all things happen in God's time, not ours. Good luck hun.

I'm so sorry, that really sucks :(

 

Who is your Insurance with? 

Oh honey, I was so happy for you with the first post and then this! WTF is right!!!!!! These people must have their heads in their a$$e$!!!!  I've heard of a lot of resistance from BCBS, but you have to keep fighting!!!! If you need a new surgeon, then do it, but don't give up!!!!
Like Katt said, everything happens in God's time, not ours, and there has to be a good reason for the delay!! This WILL happen for you if it is what God wants for you and we are all praying that it is!!!!! Hang in there honey and know we are here for you!!!

Praise God on the cancer free biopsy and 6 months of free and clear!!!
sending you bigg huggs, many prayers, and much love, Becky

Ok, use that   anger and hurt and direct it to find out what happened, did they not read the info sent, is the surgeons' office going to fight for you.  Everyone here will give you great advice, I was fortunate that I wasn't ever denied, so I just get the same info you do from the folks on here.  Hang in there, don't give up!!!!    xo  Kim