HELP

Does anyone have any suggestions about how to deal with the insurance companies. They continue to argue with me and seem to come up with different reason not to cover the surgery. Their guidelines are that I have to have at least one comorbidities. Hypertension is one of the comorbidities that is listed. I have been diagnosed with hypertension and placed on medicine for it. They say that this does not count. I have fought back and for with them. Any suggestions--I'm desperate.

Hi Michelle, Continue the appeal process outlined by your insurance co. When you have done that then you can do an independent peer review thru the Wisconsin Insurance Comissioners' office. That may cost you 25 dollars to appeal but an outside review company looks at your case and if they agree with you can over rule your insurance co. It's well worth the fight. Many of our patients have won thru the appeal process. If WLS is a covered benefit on your plan don't let them get away without covering your surgery. Email me at [email protected] and I can send you the web address from work. Take care, Mary Bariatric Coordinator