Discouraged...
Good Morning all,
I'm not sure if anyone can really help or if I am just venting. My request for approval was sent in to the insurance and declined the same day. They say I was declined due to weight fluctuations during my six months with the dietitian. During those six months I let her know that every time I went in that her scale did not match what it was saying at other doctors appointments. According to her records my weight fluctuated almost 40lbs in a matter of a month... this didn't happen. I have doctors appointments within the same week each month that show my weight within 4lbs of my original weight.
I feel like the insurance didn't look past the first couple pages or make any effort to actually look at my records. The surgeons office says that if the dietitians office will write a letter stating there was an issue with the scale and so on that they will appeal and do a peer to peer with the insurance company. However, The dietitians office is not willing to put anything in writing do to not wanting to cause issues with other patients or anything that might open a lawsuit.
HELP!!!?!?! Is there anything I can do? Any suggestions for the second appeal? Will I have to go through everything again if I'm completely denied?
Ask your surgeons office will to submit your medical records from your other doctors appointments for a peer to peer with the insurance company and have them explain that the dietitians information must have been an error incorrect. Worth a try. Good luck to youtand I hope someone that has experienced the same problem can give you better advice. You may have to start the process over with another surgeon/dietician. If so, I would select a practic where both work together. (My doctor and nutritionist work hand in hand.)
I hope everything works out for you. I don't know what kind of advice to offer cause i would be LIVID at the dietician. Who in the dietician office did you speak to? The receptionist or the actual dietician? I would definitely bring up reporting them to the states attorney general for medical inaccuracies or something. Okay i really don't know if that is even possible. But their negligence in their practice has gotten you a denial for a much needed surgery. I wouldn't let this go (unless the surgeons office can do something) and would report this to whoever will listen. Please keep us posted.
