advice is well needed

most of your know I was denied wls last year nov because of not medical necessary  also I did not do a 6 month diet did not know that I had to... so I started my 6 month diet I didn’t do the appeal because I wanted to start over. 4 months into my 6 month diet I got a call from my surgical coordinator saying lets submit with the 4 months so my doc full out the papers and my papers was submit this week just check on my insurance website and it said pended so please anyone what do that mean and what’s the next step. I will continue to go for my 6 month diet because I only have two month left. Thanks and am going to do some prayer god knows I want my body back and I want to be healthy. PS I have emblem health(hip) for insurance.

I would think that pending, means either they have not gotten to it yet, or it is under review. I would continue the six months supervised as well, just in case they come back and say you have to do it. You don't want a break in between that may cause you to have to start all over again. I will be praying that you get the approval this time.

thank you I will continue I go back for the 5 month in march thanks for the prayer

HI, PENDING USUALLY MEANS THEY HAVEN'T GOTTEN TO REVIEW IT YET OR MORE DOCUMENTATION IS NEEDED. I CAN IMAGINE THAT THE WAITING IS LIKE BEING ON AN EMOTIONAL ROLLERCOASTER. I'M SENDING YOU BIG HUGS AND KEEPING YOU IN PRAYER!!!

thanks I think she just submitted it today she did say at the end of the week hoply i hear something in 2 weeks dont know how long my insurance will take

 I would think that pending means that your paperwork has been  received and is under review, awaiting a decision. Emblem, I believe has now taken over HIP and GHI- i have Emblem GHI and am also in NYC (I believe you are in NYC too?) I know my policy required a "minimum 6 month physician suoervised weigh in without significant gaps" (policy wording) , so I would definitely continue with your last 2 doctor visits. As long as your BMI is high enough ( I don't know if you have co-morbidities ) and you've done all of the required pre op tests and doctor visits , in my experience you should have no problems being approved.(My BMI was 38-39 and I had mild sleep apnea and pre-existing, controlled asthma and I was approved.) Hope this helps, and best of luck- I believe worst case scenario you do the last 2 months , and you will be fine and re-submit (your claim may be pending awaiting additional documentation such as the last 2 weigh ins)-saving a seat for you on the losers bench!!!

thank you so much for your positive advice

 You are so welcome. Best wishes, and I'm saving you a seat next to me on the losers bench,my fellow New Yorker!!

yes am in nyc and if I get approve surgery will be at lenox hill hospital