Denied!
Hey all. I've been around the boards for a while, but I haven't been posting much the last couple of years. Mostly I wanted to soak up what the losers on the bench have to teach, and partly because I didn't really have much news beyond "still struggling with the weight.." Last month, I got everything together and with the help of a lovely doctor here in Maastricht, Netherlands (I'm on a study abroad program), requested authorization for RNY from my health insurance through my university.
Today, they called to say they denied me because I am on study abroad for my final year & did not show a need for urgency for the procedure. They don't claim it's not medically necessary, but deny me, saying I should just wait until I "get home." I won't actually be "going home" as it's my senior year and I plan to attend grad school in Europe.
Ah well. I could try to fight it, but I'm not sure how to fight this kind of denial. Instead, I'm reading up on a clinical trial in the area for a new procedure (restrictive only, no malabsorbative properties). I'm not giving up! I'm just being flexible. Especially if it could be free! =D
Could use your support and/or advise, especially if anyone else has come across this "it's not urgent enough" business before.
Thanks!
Somayeh
Today, they called to say they denied me because I am on study abroad for my final year & did not show a need for urgency for the procedure. They don't claim it's not medically necessary, but deny me, saying I should just wait until I "get home." I won't actually be "going home" as it's my senior year and I plan to attend grad school in Europe.
Ah well. I could try to fight it, but I'm not sure how to fight this kind of denial. Instead, I'm reading up on a clinical trial in the area for a new procedure (restrictive only, no malabsorbative properties). I'm not giving up! I'm just being flexible. Especially if it could be free! =D
Could use your support and/or advise, especially if anyone else has come across this "it's not urgent enough" business before.
Thanks!
Somayeh
I would contact Obesity Law or some other group and figure out how to file an appeal. That sort of denial should be very easy to appeal as it's basically them not follow the guidelines of the NIH and probably not even their own guidelines!
If you can find their requirements online somewhere or have them send their bariatric policy to you, it should help.
If you can find their requirements online somewhere or have them send their bariatric policy to you, it should help.
HW - 225 SW - 191 GW - 132 CW - 122
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