Why are they giving me hell???

So as a few of you know here, I was approved to have the revision to DS with Dr. Barker a few weeks ago. I decided to switch surgeons to Dr. Stewart. I resubmitted all the same information and the nurse that has my case now is refusing to approve the surgery. (same one just approved by another case manager) She keeps asking Dr. Stewarts office, " Why doesn't the band work?" She thinks because there is nothing wrong with my band per the EGD then it should miraculously make me lose all my weight....even though the band has been proven to not have good results. So NOW Dr. Stewart set up a conference call to talk to the actual DR. who is the director over my case and see if he cannot explain the situation. 

So because the band does not work for me they are going to deny me and let me die? I meet all the criteria! Jessica said the nurse on my case was stubborn and would not listen to reason. She could not understand why I needed a revision that I should be able to work with my band. She said she was not very nice about it either. Our question is how can they deny me something they just approved me for? Dr. Stewart wants my first approval letter. He is going to ask them why they approved me the first time and educate them about the band and DS.

I am really upset and scared now that this is going to be a mess just because I wanted to be picky about my surgeon. =(((((

I need prayer, good karma etc ladies and gents...please. 

sending good thoughts in your direction. It sounds like Dr Stewart is trying to advocate for you. Good luck and keep your chin up!

 

I am about to do the same thing. What insurance provider do u have if i might ask. I have Aetna.

Blue Cross Blue Shield of North Carolina. Jessica, from Dr. Stewart's office said she has never seen this happen. If you were already approved then usually it just takes a few days to get it again but she also said they do not normally switched case managers and they did for me. She said she has never seen this situation before that it makes no sense. 

I hope everything works out for you. I will give you a heads up, this is common per I process claims for a major health insurance company. Hope everything works out for you. Praying!

Thank you...Question if I may...

Do they usually deny or do they just give a hard time? Do I have a right to request the same case worker that approved the first one? I am also curious that if they deny me can I still go back to Dr. Barker on the first approval or is it considered null and void now?

You can appeal it, which sounds like that's what Dr Stewart is trying to do. You should have atleast 6mnths to use the approval through Barker, however I don't know what their in house policy is in regards to that.

Thank you for the information. I really appreciate you. =)

Can you ask to speak to somebody over this nurses head? If it was already approved it should be a no brainer just stamp the stupid paperwork APPROVED and get on with it, sounds like she thinks she is the person that has to save the insurance company their money like it was her own. Good luck on getting your approval. 

Yeah, she was very rude to me when I called her as if she was above me. Dr. Stewart is going to talk to the director next Tuesday. I pray it works. Than you for your prayers.