Insurance rejection and appeals

Grim_Traveller
on 8/16/17 11:05 am
RNY on 08/21/12

There is nothing wrong with going through the approval process. Some people get RNY covered because of extreme gerd, rather than for weight loss. Appealing is a headache and a bunch of your time, but if the surgeon is willing to try, why not? Just don't get your hopes up.

6'3" tall, male.

Highest weight was 475. RNY on 08/21/12. Current weight: 198.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

H.A.L.A B.
on 8/16/17 12:08 pm

plus = - if the doc put in writing the surgery is medically necessary - get copies of that. and if they approve - great- but if not- and you need to self pay - you have supporting documents to submit the cost of the surgery as tax deduction (if you qualify). taht what I did . i was self paid and I gave my accountant the paperwork and I qualify for tax deduction. At least I had to pay less taxes that year.

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

Sharon SW-267
GW-165 CW-167 S.

on 8/17/17 12:43 pm - PA
RNY on 12/22/14

RNY cured my reflux - my RNY surgeon fixed my hiatal hernia and did the RNY procedure. The best!

Do you have a hiatal hernia - if a hernia repair is covered, the additional RNY might not be that big of an additional cost (in case your appeal is not successful - which I hope it is, but you can never tell.)

Hang in there,

Sharon

laurenrea07
on 8/23/17 11:43 am

So you are saying the way you went around it was apply for surgery because of a hiatal hernia? Is the RnY only work for that? I have a Bariatric exclusion on my insurance and Im trying to figure ways around it or how to appeal.

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