Trying not to freak out!!!!

Alright, I just received a paper in the mail from my insurance. This is actually a medical review company for my insurance. But they are saying I am DENIED!!! When I read that I just wanted to cry and now I actually feel sick to my stomach. I had already talked to my insurance before this whole process started and they told me I would be covered. I am trying not to freak out because I know this happens to others as well and they still have positive outcomes. It is just hard when it happens to you!!! Here I am thinking that I am only waiting for a date and now I have to get up and fight too. I am a little stressed at the moment I have put in a call to Barix insurance dept. Hopefully they will call me soon. Robyn

Did the paper say why you were denied? Maybe you could call your insurance co. and find out why and what you need to do to get approved. Stay calm, and bug these people until you get an answer. You will be in my thoughts, and prayers, I've been through this so I know exactly how you feel right now. Just hang in there, and keep pushing for answers. Dana

This is their exact wording: PHCS has determined that the requested services are not medically necessary and are therefore non-certified. I was just so upset while I was reading it. There are lots of fancy words used and I can't understand half of it. I just wish the insurance dept would call me back and tell me what I can do to help. When I get in this kind of mood I am a good worker because I want to "fix" the problem. Robyn

Hey darlin', I know you are upset. Take a deap breath and start your "work." Call the insurance company and find out what is medically necessary? You are right, things will get better, it is a dreary day outside which doesn't help any. You may not find out anything until next week, so try to focus on something else for now. You WILL get to the bottom of it. You know I will do what I can to help. Let me know, I am just a phone call away! Candi

Robyn Sorry about this little setback. Hopefully the insurance dept will call you back and then try not to stress over the weekend and start on it next week. It will all work out in the end. Dianne

Robyn, sorry to hear about your letter. Hopefully it will just be a mistake or a misunderstanding and you will be able to get it all straightened out soon. I know I called my insurance company again just to make sure what they concidered "medically necessary". Thank God I qualify for both. I don't need any medical supervision or anything like that. The only other fear I have right now is that my company will change insurance companies on me next month. I called them too, and everything should stay the same. I will keep you in my prayers and will look forward to your post on how this all turned out great and they gave you a date. Good Luck, Deanna

Hello, It's me again. Just to let you know, my insurance coordinator called from Barix and here's the scoop. My insurance said that I need to have a psych evaluation and a nutrition evaluation before anything else will be done. After I fax the needed information to them it will be anywhere from 2 to 6 weeks after that before I hear anything. I am just so frustrated right now. I am happy that I know what to do now but upset because I have been waiting for 5 weeks and I could've had this stuff done a long time ago. So, now I need to wait through the 3 day weekend to make the necessary appts. I am just praying that I can get in quickly to both drs and that they will send the information quickly. What a pain!!! I know it will get better, it just stinks right now. Thanks for listening. Robyn

I thought you'd gotten the list of prerequisites from your insurance company before you went to Bariax. That totally sucks. I would call and get a list from the insurance as to EVERYTHING you need to have, do, etc in order to get your final clearences for surgery. We basically get a checklist of doctors appoints that we need for clearence. Our list is: EGD, Cardiologist, pulminologist, endincronologist, psyc consult, dietition, blood work, nurse practitioner, and any other specialists that any of those doctors feels is necessary. Usually taks about 3 months to get all of the final clearences. Good luck!

Dear Robyn, I had my wls at Barix in Langhorn Pa. on 8-31-05 I had lap rny I went in Wed at noon and was out Fri. by noon And Walmart on Sunday.I felt wonderful!!! I had Dr. Brader He was WONDERFUL!Barix Clinic is the best! I worked in a hospital for 12 years belive me they know there stuff. Everyone was so nice and right on top of EVERYTHING. They even have fresh flowers for you in your room.I live in Bear Delaware hon If you'd like to talk look me up Deb& Rob Ross. Hon Belive me Barix and wls is worth the wait . My insurance had exclusion so I was self pay $ 25,500. Had to take out home equity loan. But hon worth every penny I feel I'm worth one new car in my life.And you don't have to rotate my tires.Also Robyn My daughter had wls also she's 31.So dear this is just a bump in the road of life your time is comming. ((((((HUGS)))))Debbie Ross