Denial letter is mistaken!
My denial letter for my RNY revision with BCBS states "patient had RNY bypass and successfully lost weight but has regained weight". That is NOT true...I have not lost 50% of excess therefor...not successful and I have not regained any...but still weigh 298...down from 462...and have a BMI of 51. They obviously didn't read my file thoroughly, but after my surgeon called they are saying I still have to prove there was a problem with original surgery that has cause the stretched pouch and stoma....shouldn't they just have to treat my morbid obesity?
I have Lipedema and Lymphedema. I also have a passion for Obesity and Health Insurance Advocacy.
Blog: born2lbfat.com Facebook: Born2lbFat Twitter: @born2lbfat
Somedays I don't know which annoys me more BCBS or the surgeons office...
But I will prevail...and soon...I was soo irritated with BCBS on Friday for having told me they would allow my PCP to call in but when she did they would take her call then when I called they admitted that was a mistake they should have taken her call that I pouned out about 1/3 of my appeal letter...but now I have to demand a meeting with my surgeon to get some medical facts straight when I e-mailed then nurse to just ask her she said she couldn't answer them for me and to just take my reports to my PCP and have her clarify things...what the heck...how would my PCP be able to answer questions as to what my surgeon found wrong in upper GI, endscopy, etc. to merit a revision...and shouldn't that all already be somewhere as it should have already been submitted once to BCBS!!!!
I have Lipedema and Lymphedema. I also have a passion for Obesity and Health Insurance Advocacy.
Blog: born2lbfat.com Facebook: Born2lbFat Twitter: @born2lbfat
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