Help with Healthfirst, Pls!!!!!!

shoustone
on 2/5/06 11:19 am - Arverne, NY
I've been denied by Healthfirst and my surgery date is 2/13, can anyone help on how to appeal this decision?
jamiecatlady5
on 2/5/06 6:01 pm - UPSTATE, NY
Sheba: What does the denial say? Why are they denying? (does your plan cover barkiatric surgery? are you meeting citeria? (BMI over 40 or over 35 if w/ 2 comorbidities) Do you have medical necessity documentation? Call teh surgeons office work with person who submits ins. ppwk and discuss. Do you have a copy of the denial? If not get it! Call ins. find out why. Do u need some final test or a 6mo preop wt loss documentation of diet? Take Care, Jamie Lap RNY 10/9/02 Dr. Singh 320/163 5'9'' (lost 45# before surgery) Plastics 6/9/04 & 11/11/2005 Dr. King "Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
(deactivated member)
on 2/5/06 8:59 pm - MT
Sheba, Can you give more info on why you were denied, it will help to know..... ~Hugs~ Debra P
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