I have been denied

Can anyone tell me what to expect now that I have been denied?

You can put in for an apeal to try to get them to approve it.

Why were you denied? That's something you need to know, if it's because of something they didn't recieve, or something that still needs to be done, or does your insurance have a clause specifically stating no procedures for obesity...Those are all things you need to know and then you figure out the proper steps to take. Good luck to you

Did they tell you why you were denied?  Does your insurance have a WLS exclusion for all surgeries, do they have special qualifications that you didn't meet, did they not get all the tees crossed and i's dotted?  To fight it, you need to have the reason.

Caroline

Caroline, Thankyou for your reply. I hope I do not have to contact a lawyer. Thank you just descurrage me even more. My drs. have sent in th appeals to both of my insurances. I don't what happend the office should know what th einsurances want right? But still I have been denied by both hummm Jones

I highly recommend contacting Obesity Lawyers.  I was denied and tried to do the paperwork all on my own.  Some of the hoops that you jump through, you can only do once.  Obesity Lawyers know exactly how to file the paperwork and exactly how to follow-up.  Trust me, it is well worth it!

Definately see why you were denied. I handled my own appeal, got denied, and then was approved when I requested an outside hearing. You need to know why and what the appeals process is. Once you know that, it's easy. My original doctor didn't want to file my appeal, so I did it for myself. Good luck!

Thank you for your  reply The dr. has sent in th eappeal. I WILL ASK FOR an outside hearing if I need to. Thank you for that I woulod have not known about it. Jones

Make sure you have a copy of the denial for yourself. It has all of the appeal procedures and options in it and why they feel you don't qualify. Just in case, start working on what they say you're lacking.

Thank you Sharon, I do have everything and the reson for denile seems to be not enough info. from th edrs. and nutritionist. I do hope they get it together. I was thinking that if I am denied again I would go to a different group one who has been doing this for many many years in cleveland oh. I wonder if that would increase my chances? I guess I I will find out if this does not work. Good luck with your weight loss and I keep you posted Jones