Anybody know???

If you can get approved for the WLS process.  And go thru the insurance requirements like Psyc, tests, Nutr. etc and then after you finish all that.  Can insurance deny you when the Dr.'s office submits the paper work for surgery approval.  So after all those appointments can Insurance deny surgery? 

Not sure why this is haunting me lately.  I am so worried that I go Thru all this with hope That I will have surgery and for some odd reason insurance can come and deny surgery, although you have done all that they have asked for. 

I Know I should ask my incurance company but I put a call in for them today and they left me on hold forever while I was at work then I had to go.  I willhave to again Monday but I was wondering if any might know the answer.

Going through the steps is only part of the process.  Unfortunately, yes...insurance can deny you and there can be a whole list of reasons.  Your doctors office though, will not submit paperwork on your behalf if they are not convinced you qualify.

The GOOD NEWS is that denile is usually not the end of the road.  It simply means you step up your own advocacy, appeal and fight for it.  It's rare to see someone who qualifies and has insurance that covers WLS be ultimately denied.  

Good luck,
Paul

Yes they can and many times they will....never give up that is what they want you to do!!

Good Luck!

Hugs....connie d

I was denied for surgery the first time I submitted for it because they didn't think i completed the dietary portion of the requirements for BCBS.  I did my research through all of the information that was gathered and sat down and wrote a letter to them detailing everything that was done, the conversations that were had and what not.  Then I had it resubmitted to insurance by the docs office and they then had a bariatric specialist review it (IDK why they didn't do that the first time through but whatever) and I was approved.

Note, if you do get denied, you can appeal it through BCBS but you can only appeal it 2 times.  if you are denied on that 3rd submission, the answer is no.