Tenative Denial.... need help(self pay?)

Ok... long story short. I talked to my insurance co. today and was told their medical Dr. was requesting additional health info from my surgeon. I called BTC and was told that the Dr. was looking at denying me as he didn't feel I had enough health issues for this surgery. I guess having high blood pressure, Gerd, PCOS, sleep apnea and constant back and knee pain don't count! I am so frustrated right now it is all I can do to not cry. My surgeon won't be back in the office till Jan. 6th. I just don't know what to do. What can help my case? Should I be looking at writing an appeal even though I haven't been officially denied? I am certain he will deny me. I can't '"make up" any illnesses. HELP!!! I'm also wondering if any of you know any facility out there that will take self pay? Unfortunately, BTC does not. Any advise will be greatly appreciated! Kim Richards

Hi Kim, Believe me we all know your frustration. Who is your insurance carrier? I would have an appeal ready just in case you do get the denial. As for self pay. I know that Scottsdale Bariatric take self pay and so does the Wish Center. Keep your chin up hun and know that we are here for you with our fingers crossed and to help in any way we can. Keep us informed. Tammy

Thanks Tammy, I appreciate the support and information. Please pray for me. This is so stressful! Kim

Who is your insurance with? And which doctor is thinking of denying you because you don't have enough health issues? Your surgeon or the insurance company doctor? . If it's your surgeon who is wanting to deny you I would find another surgeon who takes your insurance. Because you have more than enough co- morbities to qualify for the surgery.If it's the insurance companies doctor who doesn't think you have enough co morbities then you should appeal it because alot of insurance companies will deny you the first or even second time around. As for self pay....Dr. Blackstone who is awesome, offers a reduced fee for self payors.

Hi Jennifer, It is the insurance co. Dr. who is leaning towards denying me. I never even considered a denial because I didn't have enough health issues. What a joke. I WILL appeal of course. My insurance is with Great West/One Health. Thanks for the info on Dr. Blackstone! Kim