Revision from VBG to RNY - Keystone Healthplan East

Rhonda S.
on 2/8/09 3:44 am - Bensalem, PA
I received an initial denial for my RNY less than 24 hours from my scheduled surgery  by Keystone Healthplan East [ Independence Blue Cross HMO] - upset doesn't even cover how i was feeling.  My understanding is that I was denied because its a second bariatric procedure - even though the first was 22 years ago- neither they nor any of their affiliates paid for it and I have documented technical failure -on top of a high BMI.  The way I read their bariatric surgery policy and how they are reading it seem to be different.  I have appealed and I understand my surgeon's office is appealing too.  Anybody else go through this? 

I will cross post this on the insurance board, but since this is the PA board, I thought there was a greater chance of somebody dealing with Keystone Healthplan East.  My general experience with them up till now has been positive.  I know I'm not the first person to go through a denial nor will I be the last but it feels very disheartening - like being kicked when you are already down.
Ready4 AChange
on 2/8/09 9:26 pm - Upper Chichester, PA
I haven't had any experience with KHPE ( I had Personal Choice with my surgery) But I just wanted to say Good Luck ! Just keep appealing maybe they will tire or realize that this is medically necessary for you.
I wish you my best.
Sandy

Sandy  
        
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