First denial letter

Hi, my name is Lavonne, I've been reading the board for a few months. I've been in the process since September. My physician is Dr. Curry, wonderful man, and is always prompt answering my questions. His staff is also top notch. Welllll, I received my denial letter Saturday for the lap band and am just kinda bumbed out about it. Haven't been able to vent to anyone so I thought I would try the board. Evidently my insurance, Medical Mutual,thought my psychological exam was lacking information, I know it is no biggy but I'm just a little angry. I'm 56, had open heart surgery in 2000, hi triglycerides, diabetes type II and arthritis and the insurance had to pick something to question. Ok, maybe I feel better, but if anyone has any feedback, please let me know. Have a great day.

Will your insurance cover RNY? My son had the lap band and I had to pay for it in Cash. Not fun but he is only 31. I had RNY and I love it. Good luck,you have the doctor that alot of us think he is the best,Love,CIndy

Dont touch it Cindy, it will just start another debate LOL. RIchard

Did I miss something Richard????

Why should she have to switch to Rny just because her insurance said no for something that can be easily re-evaluated and resubmitted? She chose lapband after what I am sure was careful consideration, and now her insurance needs to ante up and pay for it. She is entitled to the surgery that she and her doctor feels is best, if it be lapband, DS, or RNY. Also, maybe I missed something, but her insurance didn't say no BECAUSE it was lapband and not RNY--I think thier denial would have been the same regardless of surgery type.

Lavonne, I had Medical Mutual also and they denied me because of my psycological exam as well. My doctor wrote that I was a good canidate for surgery but could benefit from ongoing therepy for eatting issues. They hopped on that and would not cover. I got my PCP, the Psycologist and my nutritionist to write a letter as well as a complaint with the state. I started therepy to make sure I would not be denied again as it would just slow down the process which is what they want. They came back with an approval. Dont give up, fight back harder. Richard

Lavonne, I too, have Medical Mutual. It sounds as if all they need is more informaton! I thought that I was denied but actually all they said was that I was missing a couple of things....once they were submitted I was approved in 2 days! I did have the RNY so don't know if that will make a difference or not. Call them everyday! Write down who you talked to and what they say. Ask them to check medical review......that will be the most recent reports. Be persistant! You are paying for their insurance! If it pays for the band then make sure that you have everything required! Good luck! Sue 320/148/130 goal!

Thanks everyone, exactly the support I needed. I'll keep moving forward.

I also had medical mutual and was initially denied. Not because of psyc eval, however i was initially denied none the less. Med. mutual is notoriaous for denying the first go around. I had to appeal and was finally approved for RNY. Keep on them

I was also denied by med mutal because of my psychological. I didn't want to go to counseling as recommended but have been going and now I'm glad I did. My psychologist has submitted a letter so we are ready to appeal the decision. Wish me luck Dianna