denied for VSG (Empire Plan)

I have been denied for the VSG by my insurance co (Empire Plan). Doctors office advised that ins co stated that there is not enough long term data on WL to approve. They had the claim for 4 weeks before they notified me. They advised to submit claim for RNY but I don't know if I should appeal or if it will be a waste of time. I heard that insurance co's are close to adding the VSG to the list of approved surgerys. I havean appt with my Doc this morning to talk about my options. Please help!!!

i have the same insurance and i haven't even had my first consult yet and i'm already getting things ready for my appeal. you should post on the VSG forum, people there are a great resource to some studies. here is a site with tons of studies. did they automatically deny you? or did they ask you to go on a 6 month supervised diet first?

 

http://vsgfaq.com/forums//index.php?s=3a6ec21b15e853a5365e4a09ad4ffcf5&showforum=39

 

http://www.facs.org/education/gs2004/gs33lee.pdf

 

hope it helps

oh yeah and if you're talking about empire blue cross blue shield, go to dr roslins (same offices as yatco) surgeon's page on this site, click on insurers, youll see he has patients that have had VSG done and were insured by empire bcbs so there has to be some way that they can approve you. it might be hard but it can be done! good luck!