Denied for the 2nd time!!! Need advice PLEASE!!!
Hi,
I was denied the first time by my insurance company for not having enough physician documented information.Ok fair enough. So my Dr. put me on Adipex,Metformin,Victoza, and Topamax just for weight loss alone. I was on prednisone for a long timelast year and had gained even more weight. So the steroid weight fell off and I lost a little on the pills, but I am so sick all the time from them. Everything was set and they denied me the 2nd time because I lost weight from the pills. Well I was told it was good to lose some weight from the surgeon who was going to perform the surgery. He said it helps prove that I can follow through after surgery. All the other diets failed and even after the weight loss my BMI is 41, and I have sleep apnea, GERD, Fibromyalgia, arthritis, depression, chronic lower back spasms, and anxiety. I am 31 years old and take 15 different meds. How can they say diet drugs are safer than surgery? I can't live on them forever! I have Physicians Care ASR through my job at the hospital. I was told I could write an appeal letter, I am not sure how to go about it and I was wondering if anyone knew any tips on getting through to these people. Thanks- Meg
I was denied the first time by my insurance company for not having enough physician documented information.Ok fair enough. So my Dr. put me on Adipex,Metformin,Victoza, and Topamax just for weight loss alone. I was on prednisone for a long timelast year and had gained even more weight. So the steroid weight fell off and I lost a little on the pills, but I am so sick all the time from them. Everything was set and they denied me the 2nd time because I lost weight from the pills. Well I was told it was good to lose some weight from the surgeon who was going to perform the surgery. He said it helps prove that I can follow through after surgery. All the other diets failed and even after the weight loss my BMI is 41, and I have sleep apnea, GERD, Fibromyalgia, arthritis, depression, chronic lower back spasms, and anxiety. I am 31 years old and take 15 different meds. How can they say diet drugs are safer than surgery? I can't live on them forever! I have Physicians Care ASR through my job at the hospital. I was told I could write an appeal letter, I am not sure how to go about it and I was wondering if anyone knew any tips on getting through to these people. Thanks- Meg
I went through the process 3 different times but for denials on the surgeons behalf. I would say write the letter, get documention from every dr you have seen in the last 5 yrs! They need to say what meds they have you on and what for, and how long. Also have them state what advise side effects you've had from the meds. Your appeal will be thick, but this should help you move along. Send pictures if you have them too.
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