Denied

I just got denied for the surgery. Insurance said I didn't do 3 things that are required, which I most definitely DID do. Six month diet: Check. H.Pylori test: Check. Cardiac Clearance: Check.

I know I did all the things required, so having it denied for those reasons is disheartening. My center sends in these packets all the time, they were the ones who knew all the things I had to do to get approval... So it's like being denied for just to throw in another hurdle. And now I'm no longer certain I'll be approved because... they denied it for totally crap reasons!

Sad :(

if you have done the things,your center only needs to resend the items missing.

The thing is, I'm sure they sent that stuff. The nurse went over all the information that they needed to send with me two days before it got sent.

I've left a message for her about dealing with the approval, and I'm going to ask her for a full copy of what was sent in and the other reports, if they're missing. Just so I can have it here and start building a file in case I need to have an official hearing.

But it is very disheartening.

I also got a letter of denial and called my surgeons office. By the time I called then they had also received the denial and sent the missing paperwork to the insurance company. It was approved two days later.

Apparently when I typed this a minute ago, it got eaten by the board.

That's a fantastic way for the denial to get righted! I can only hope I'm so lucky as that.

One positive I can say for myself: I just realized I didn't have a WHERE'S MY SUGAR?!?! reaction to this all, even if I felt my face get all red and my eyes went damp, had no comfort-food knee jerk. Go me :)

Be sure to follow up on this. That is a relatively easy fix. 

I will, I've already put in a call to the nurse navigator.

I may need medication if I have to go into another 2 week wait only to be denied again for another crap reason.

There is an appeal process when you have been denied. If your center is certain they submitted everything I would call insurance and ask what they believe is missing and ask how you can resubmit info. If they give another reason for denial (they'll do this sometimes to try and deny coverage because they don't want to pay out on claims) ask how you would go about appealing the decision. I am sorry you hit a wall but you can make this happen if you want to if you remain positive and diligent. :D :)

I've already begun my calling frenzy, or as it shall become known in the records: My reign of terror... :)

Last night when your post came, I read it, then slept on whether or not to respond to one part that's actually bothering me. Not bothering as in I'm angry about it, but bothering as in... this is an example of an unhealthy emotional practice.

I know when you said to be positive, you meant it in the best possible way, but being told to be positive about something feels like negating my right to feel angry or sad about a thing(like the idea that there's nothing morally wrong for an insurance company trying to deny coverage because they don't want to pay out on claims... that's something righteous to be angry about!).

That's not how you intended it, and normally I wouldn't say anything about this because that's how life has taught me to behave when something upsets or angers me--Be pleasant, be sweet and accommodating, don't do anything that paints me in an even more negative light to the rest of the world than me being obese already paints me. But putting on a false positive front and stuffing down all those other completely legitimate feelings is the kind of mindset that leads people(like me) to comfort themselves in less-healthy ways. Comfort Foods, for instance. This is a cycle I'm doing my best to break! Venting is probably what stopped my historical knee-jerk reaction to reach for something sugary yesterday.

It is okay to be a fat person and feel angry, or sad... to be disheartened. It's okay to be something besides happy, positive, sweet, or cheerful. I can still be professional while I'm feeling angry. So can you. If something upsets you, venting to people who'll understand the frustration and the fear is a good thing.

No emotions are bad. As human beings--even as fat women(gasp!)--we shouldn't have to put on a fake smile when we just aren't feeling it. If we're angry, be angry. Acknowledge it. Feel it. We're allowed.

xo