I am frustrated waiting.

I was told today I was denied by my insurance company, Anthem. The MD's office originally lost my paper work and six weeks later after I called them they submitted it without listing any morbid conditions. Now I can't get a hold of anyone in their office to tell me what is the next step. I do not want to start all over and pay another consultation fee with another MD. I am so frustrated. Physicians office had said that it will be three months after approval before I can have surgery. I am soo tired of getting nowhere. Any advice?

what was the reason for the denial? APPEAL APPEAL APPEAL.......you will not start over but you will appeal..stay strong this is the fight for your life

I was denied because the physician's office did not list any morbid conditions. I tt the ins co and they said to have MD call this 800 number. I can not get a hold of anyone in the MD office to tell them this. I have GERD and Diabetes so I definitely qualify. I am wondering if I could transfer my records to another MD's office and not have to go thru another $300 consultation. I want the surgery yesterday. Just like everyone else does I am sure. I have NO patience today. Thanks for listening.

I had Anthem BC/BS (I'm convinced BS stands for B*** Sh**, not Blue Shield! )and was denied (2yrs ago). I just didn't bother jumping through all their hoops to re-submit my ap and paid out of pocket. Now, as I understand it, the ins requirements have changed since I applied so you should be able to re-submit your ap. BUT if your Dr didn't send the ins the correct info (morbid conditions) you should be able to just call the doc's office and have them send that to the ins. I don't think you would have to pay another consultation fee, esp if they are the ones that neglected to send the proper info in the first place. BTW the words 'frustrated' and 'insurance' always go hand-in-hand Don't give up yet, just keep on everyone's case. Good Luck! Hope

I feel you pain! I too am waiting and dealing with ins. I'm waiting to hear the results on my appeal. Hang in there and don't give up! Cheryl

I too have Anthem but unlike Hope, I have had a wonderful experience with them. Who are you referring to as your consultant? A regular MD? That doesn't sound right. If it is your regular doctor, you should not have to pay a surgery consultation fee. Afterall, it's a referral that you are asing for from him. If it is a surgeon, then you have probably chosen the wrong surgeon and best you find that out now. I did not have to pay a dime for my surgery consultation. I did have to pay for my psyche eval...~$100-125. If it is your family doctor, switch doctors and have them request all of your records from the first MD. If it is a bariatric surgeon, bite the bullet, go to a different one, but research the new one first. Come on here and see if anyone has any input about him/her. You should not have to pay anything for the consultation provided you are planning to have the surgery with them. A good bariatric surgeon's office would not make the mistake of not including co-morbidities. Contact Anthem and ask them how long you have to wait to resubmit if you are going through a different surgeon. Explain to them what you have explained to us...that the other one has been unreachable. After you see a reputable surgeon, resubmit. By the way, most people have their surgery within weeks, not months, of approval. After you recieve the approval, the only delay is the surgeon/hospital schedule. Even our busiest surgeons here in Indy can manage to get people in for their surgery in less than 3 months. Best of luck! Sherri

I had great luck with Anthem too. I even got reiumbursed for my psych visit. Out of pocket was met because my surgery was at the end of the year. My total cost, was something like $2 I owed to Dr. Inman's office (ack, don't throw things at me! Hehe.) Keep on fighting for this, you can get them to do it. One lady, Penny, in the Terre Haute support group said how she just gave them so much information, and had it in graphs, and color coded and such that they couldn't make an arguement against it. Linda Vicory

I was much like your friend Penny. I had all of the informations separaed into sections with cover pages and title pages for each section. The sections included: Physician letters, physician notes, medical tests supporting co-morbidities (ie my sleep apnea test results), support group verification of attendance, past diet attempts, dietician notes, my food journals (all in Excel and very clear as to food & exercise), etc. I found that the more you include (no such thing as over-kill) and the better clarified you have everything, the easier it is to get everything through the first time. Sherri

I agree with Sherri.. I had Anthem and went to Dr Cacucci and didnt have to pay her for the initial. I did pay for the shrink but I could see him 3 times on the same 150.00. It HAD to be your PCP who "forgot" to list your comorbids... any Surgeon I have witnessed always list the complete co morbids.. (weither we like to see that list or not). Try again, ask the insurance what else they want to see... Good luck!! Linda