Peer to peer review?

Insurance company denied me.  My physician's office is now scheduling a peer to peer conference with my insurance company.  Anyone have this experience?

Good Luck Dena, please keep us posted on how it goes!  

I have worked in the insurance industry for over 30 years.   The peer to peer review is another option for your Dr/Surgeon to speak directly with the case worker and outline why he wants them to approve this surgery for you.   He can bring up additional medical necessity info that might not have been available when they first reviewed the claim.   It is a common for insurance carriers to do this, after a immediate denial.  If they uphold the denial, then your surgeon will have 30 days to do a written appeal. 

Good luck! 

I didn't have any issues with bariatric surgery, but my daughter was born with a rare birth defect and needed surgery. The only pediatric neurosurgeon in our network had never done it before, so we had to fight to get her surgery paid for out-of-network.

We were denied the first time, and our doctors (chosen neurosurgeon and pediatrician) did a peer conference. The surgery was immediately approved. We were told that it is very, very common to deny the first time but not so common to deny after the peer conference since the doctors rarely go that far unless they truly have a case for medical necessity. I'm certain the same is true for bariatric surgery.

Got the call insurance company approved after peer to peer! Now to schedule ??