Anyone with Coventry Insurance?

Hello All, I just want to know if anyone has Conventry Insurance and if so, what was your experience when wls approval/denial?

Hi Nicky....I dont have Coventry, but if you check out the insurance link on this site, it seems Coventry paid for a few surgeries, but denied some. http://obesityhelp.com/morbidobesity/members/list-insurers.php?State=KS&curPg=2&alphaPos=C I would say that you need to call the company personally and ask them about "weight loss surgery exclusions" if they dont have any, tell them what it is you want, why you think you qualify and they will (or should!) answer your questions for you. Good Luck and please keep us updated!!

Mary, thank you very much. Actually, after I sent this message, I did go that link of Insurers and saw the reponses their. Take care:-)

Good Luck to you Nicky...please keep us updated on what you find out!! I'll be keeping my fingers, toes and eyes crossed for you!!

I have coventry as well and am curious on how to get started. I have done a consult with dr. already and since he is not contracted with Coventry, Coventry will not give his office and address to send the pre-auth to, to even get a denial. Where do I go from here?

I would suggest you call your insurance company personally and ask specifically if they cover WLS surgery. If they do, then ask them what Bariatric doctor is in your netowrk. I went online to my insurance's website and found a few doctors then confirmed with my insurance that they were in my network. Good Luck and let us know what happens!!

I was just informed that no matter what coventry does not cover WLS even if it is deemed medically necessary and you can not appeal it.

this most likely is a provision setup by your employer. I am a state employee in the same boat..... check my other post above..... Sorry about this obstacle for you.

I can tell you that you should have a good pre op doctor office.(Not surgeon) His office helped by following through on everything in paperwork. You can also ask for reconsideration. Check with your insurance "what was submitted by your surgeon and is everything in?" You might be surprised what they have. Make sure they have all pre recs. I went to my pre op physician and got copies and faxed them myself, They did not have all copies of monthly visits that surgeons office was to send. My doctor (pre op) also wrote in favor and so did my husband. I was reconsidered and passed a few days later with all info in. Sometimes its pushing the info and staying on them. Also ask for the nurse who oversees cases in your state for your insurance. Get the number and talk to them. Make sure you do this. They can tell you exactly what you need. Do not depend on surgeon office.

Hi Nicky. My name is Nikki Washington. I'm not sure what the other people who have replied to your post are talking about, but I have Coventry for Federal Employees and they DO APPROVE surgery if it is medically necessary. I just had RNY gastric surgery on 2/6/07. Coventry made me jump through some hoops though, getting approvals from cardiologist, pulmonologist, dietician, psychologist and I had to have tried to dieting and exercise for at least 3 months. Once I completed all of that, my surgery was approved. As far as time was concerned, I went to the wls seminar at The Bariatric Center at Shawnee Mission Medical Center on 10/24 and completed everything by December. My letter for approval was submitted on 12/29/06 and I was approved on January 17, 2007. The point is I WAS approved, I just had to follow their rules. Any questions feel free to contact me here or at my work email: [email protected]. Good luck, Nikki