Denied!

I have been waiting for approval since October and learned today I have been denied due to lack of documentation. They want documentation that I have been obese more than 3 years, ok can do that. Documentation I have tried to loose weight for 6 months prior to asking for surgery. I know I have done that but not sure I can prove it?! I submitted a letter with the surgeons stating all the diets I have been on, but apparently they are not accepting that. Any advice?? Thanks, Karen

Same thing happened to me, too. It is just a delay tactic. But, like everyone advised me, play the game. Follow the steps. Do as they ask. Allow a reasonable amount of time, then, call them for a response. Persistence is the answer. Good luck!!!

Thanks Karen! I have 90 days to give them the documentation then I have to start over from scratch! I am pretty sure I can give them most of what they are asking. Just not sure if I can proof all my diet attempts! I had written a letter to them about it but they want more! How long did it take for you to be approved? Karen

I'm sure you will have to have a medically supervised diet history with a physician. One in which he/she prescribes diet, exercise and behavior modification and you will need to go in at least once a month to weigh and consult with the doctor. You can call the customer service number on your insurance card and ask them to tell you exactally what it is they want. They will be more than happy to help you. We are running into this more and more with insurance companies, it is a pain, but it can be done. Just make sure your physician knows how important it is that they document EVERYTHING! Feel free to e-mail me, I'll help in any way that I can. Just don't give up.

Thanks Melissa! I don't plan on giving up easily! They told me it could be documentation from WW or any place I went. HOwever, not sure I was anywhere for 6 months straight! So, I will see what my PCP says next week. I hope I don't have to wait 6 more months but I will if I have to! Thanks, Karen

Sorry about the denial Karen. Your profile didn't have much information. Who is your insurance company? Do you have a copy of your summary of benefits? You need to really know what the plan actually says. Is the company you work for self-funded? 12/22/04 lap rny -15#