Frustration!!!!

Hi everyone! I just needed to vent! After spending the last weeks doing all my testing and getting everything together for surgery in August I get a call today from my insurance company saying im not covered! I was sooo mad because my Dr. specifically called and double checked. When I spoke to them today they told me they gave my Dr. office the wrong information when she called and told them I was def covered!!!! Now my only option is to file an appeal!!! Any help what so ever would be great!!! Thanks Nicole

I'm so sorry to hear you've hit this road block.  APPEAL!!!  Have your doc send the appeal in for you!!!  Lapband had not been approved by BXBS Excellus at the time I began my process.  My doc met with the Medical Director for BXBS.  Shortly after the procedure was approved, then I got my approval. Good luck, sweetie!

Hey, yo know all those times you hear the message, "this phone call may be recorded for training and customer service?" Well insurance co's do that- ALL the time! It worked in my favor once when I was trying to get an Rx for Meridia. They said I had to be in an approved wt-loss support group. So I called and asked if TOPS was one and the man said yes. WHen I was denied the prescription, I called back .It was because TOPS was not one of their approved groups, but I had documentation of when I called and who I spoke with so they said I was correct and approved it. I am sure your docs office has record of that phonecall, or at least they really should have if they are worth their salt. Get that documentation and call them back! Don't give up! tHIS IS TOO IMPORTANT! Good Luck and Keep Fighting!

File an appeal.  You might also want to consider contacting one of the attorneys that specialize in helping get approvals for wls such as Gary Viscio (http://www.obesitylawyers.com/). Mary

Nicole - I'm not to sure from your post if you were denied because your insurance company doesn't cover wls, or because you failed to meet your insurance company criteria to have wls? My insurance company Aetna PPO orginally denied me for wls because I didn't have 6 months of documented medically supervise dieting, once I provided this info my insurnace company approved me. If your insurance compan doesn't cover wls, then you should appeal it; because if wls is deemed medically necessary they have to cover it.  good luck....keep us posted. donna