ANTHEM DENIAL

has anyone who has been denied by Anthem for a reason that they want you to do the liquid or your own dieting before they approve, went thru all that maybe didnt lose that much or may did and that changed their tune to approve for surgery? Fighting with them this morning on denial and just getting prepared to go at it whatever.....thanks

Alot of insurance plans request you do 6 months supervised dieting first.. I had Anthem but I didnt give them a chance to turn me down.. when I submitted my request for surgery i had proof that I spent 18 months trying it at a weightloss clinic ( reciepts with weight gains and losses on them) and proof from Weigh****chers..

Good luck...

Linda Kay

I SEE...so if i have to try the drs weight loss plan for awhile, then if i fail more than likley they will review again and see that i had no success. Its been nothing but up and down with them. Thanks for your reply!  

When you turn in your request for Surgery you could also send your hand written (or typed) letter explaining all the things you have tried in the past to loose weight with no success.. I did that too.. I told the about dexatrim... grapefruit diets, hypnatisim (sp) other support groups online and off.. Just be truthful and hopeful... I know they cant string you along forever if you are detiirmined.. And if you have decided on WLS then I am sure you must have already tried everything else because WLS is not for the weak in spirit but the ones willing to fight for what they want because WLS is NOT I repeat NOT the easy way out.. Talk about life change... Dont get me wrong... soooo worth it but not easy or for the weak...

Best of luck,

Linda Kay

I was originally denied by Anthem.  When I resubmitted I included a handwritten letter and a set of 10 pictures of myself ranging from toddler to present.  It was suggested to me to do that to make them see me as a person and not just another chart full of impersonal facts and figures.  Not sure if that was the turning point but I did get my approval about three weeks later.

well i surely can do that. Waiting for them to call me right now to see what it is they ACTUALLY want from me...i have my letter formed on what i want to blast them with. What irks me is that they denied me over a week ago and no letter had been sent to me nor had they contacted the surgeons office. thanks for the suggestion as i will try that.  

sweetie
you just jump thru their hoops and do what they want..
dont give up!!!
my pcp said thats the main reason most of his overweight patients dont end up having the surgery...they start doing their supervised weight plans and in middle say its not worth it...etc...
you just do what they want...
it'll work out!!
hugs
p

i know i am going to keep on track just as you are with your setbacks. hang in there too! we will eventually get to the losers bench....

Which Anthem is it?  The Anthem Blue Cross and Blue Shield of Indiana approved me fairly quickly (once they got my physicians paperwork) without any stipulations.

Are you with another Anthem?

yep! Indiana...not going to be a nice call today to them when they open....first time they didnt get all the info from surgeons office and the they refaxed....then its drag drag drag...