denied.

   I got my denial this morning. I am not fat enough, and i havent been obese long enough. So basically if I gain 25 pounds I will be fat enough, and wait 2 more years I will have been obese long enough.  I consider being over 200 pounds since 13 obese for long enough. Well lets just say that upset me quite a but. so I went down to Mercycare and talked to a supervisor. SHe was so sweet as I uncontrollably cried :( The lady let me  know that they didnt recieve the whole phychiatric eval, so I called Nicole and she faxed it right away. They are being really anal about the 6 month supv diet. Even though I have been on doctor supervised diets they havent been documented exactly month to month.They were very nice and gave me a expedited appeal, so I should know within 72 hours :( If I get denied anyone know any docs who take monthly payments? :(

Awww that stinks. I'm so sorry to hear that. Did they imply that if you do the 6-month they might reconsider? I don't have your insurance company, but I know that I didn't have a 5 year history (I did but one year wasn't properly documented) and was missing something else, but I did get in that EVERY-MONTH visit to the PCP for my weigh in and discussion of weight loss effots.  You may not find a doc to take payments, but what's to stop you from putting monthly amounts into savings? There are also companies who finance big surgeries like this.

Sorry to hear that. I will keep my fingers crossed for you.

Oh no.....bless your heart.  Just keep working at it.....and there is a good possibility that the appeal may  come back as positive since you took the time to go to Mercycare and show them that you are a real person, with a real problem.  If you get denied....pick yourself up and go after them again...keep on till they groan when you come through the door. Here is hoping those 72 hours pass quickly and that you are winner  when it is over.  Crossing my fingers for you! Gena

I am so sorry but please do fight it ...Lisa

Ride  Mercy Care until they say uncle and approve the surgery!!   Candy

They denied the appeal. Im sure it is because they want me to do a monthly check in 6 month diet, i have done several in the past my doc even said that in my letter, but they will do anything then pay for surgery. And I they want me to lose 5%, but then my bmi will be waaaaay less than 40, I am at 38 now. Its a no win situation. Anyone know a doctor in the US that takes payment plans? Our credit is not good enough to finance right now. If not I may look at mexico...eek.

If they tell you to lose 5%, they can't deny you for LOSING 5% I'd do the 5% (but not more) and the 6-months, and see what they say.

They denied my appeal. Actually they denied me because they still had not received my phyche eval and nutrition consult. They didnt even say anything about the 6 month. Funny because It was sent immediately after I walked out of there office. I went to my PCP had her write another letter, then went down there again.  I have to say I am more than devastated and pissed off. I told them it was sent and they basically said "sorry sucks to be you". Now I have to go through the fair hearing process. I submitted today. I wish I was getting my surgery next week like I had been hoping, looks like I will just be waiting weeks to get a hearing date. Probably wont be around much. :(

Are you hand carrying it yourself?  I know how frustrated you must be.  All I can say to make you feel better is it will be well worth the wait.