just my luck!!!!!

Hello everyone--well my doctor submitted my paperwork on the 30th of November so I decided to call my insurance today to see if by some slim chance I could get an answer---well Im glad I called--they said a letter was sent out on December 1st and I should receive it any day, well they were right I received it today and it stated I was denied due to an exclusion in my policy--well I had verified my coverage with 3 different people well before I even thought of making an appt to see the surgeon so I knew this couldnt be true, WLS is covered under my husbands policy--luckily cst srvc was still open this evening when I called and now after being denied I need to wait again because they aggreed that my policy does cover WLS and now they need to resubmit it with the supervisor tomorrow and I will then need to wait again to see if I get the approval--Ugh---apparently the dept that handles the approvals didnt have the updated version of my coverage with my husbands company so they denied me---I hope the second time around I am not denied for another reason---they said they would follow up with me tomorrow by phone to let me know what is going on--im keeping my fingers crossed--how frustrating----thanks for listening, I had to vent--Take care---Lori

Waiting is HELL..but keep a positive frame of mind and do whatever you have to do to get approved..in the long run it will all be worth it. Good luck!! and Hang in there.

Lori, Insurance companies are a pain, but it is well worth the aggrevation! Hang in there! Vickie J. 277/152/142

Lori- you have Cigna like me. Here is a link to the PDF that will talk about the exclusions for WLS: http://www.cigna.com/health/provider/medical/procedural/coverage_positions/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf I can't copy and paste from the pdf but it says (pulled out of context) CIGNA covers bariatric surgey as medically necessary when ONE of the following are met: Individuals with BMI greater than or equal to 40 for at least one year, when ALL of the following are met: blah,Blah, Blah I'm just now entering my six months of diet documentation. Oh yeah, I really HATE having to wait but I'm keeping positive and staying busy... Hang in there and know that better days are ahead.....

Getting through the insurance mess is by far the worst part!! Hang in there! Jan

Thanks everyone for all of your support---Im hoping my second letter will be the one I want--THE APPROVAL-- Lori