I am needing your help!!!!

Paula Chapman
on 7/23/07 11:00 am - Midvale, UT
I don't really know where to begin.  I have medicare, bought a PPO medicare provider, Unicare.  I meet the criteria for WLS.  I am going to a 'Center of Excellence'.  I have been denied, they wanted a psych eval.  I did that, my surgeon sent it in, surgeons office says I was denied again.  I called the insurance, the customer service rep says they have no record of a second denial.  Surgeons office says the surgeon is going to speak with the insurance this week on a MD to MD phone call.  I can't seem to locate where my problem is.  Does my insurance have a problem with me or with my Surgeon?  The wording on the first denial referred to patient safety and follow-up care.  I am confused because as a center of excellence, they are required to have the whole ball of wax.  Nutrition, group, support, diet, exercise, aftercare.  So I hope someone out there can help me.  Any advice? Thanks Paula
.::Princess
Nutmeg::.

on 7/23/07 3:13 pm - Rohnert Park, CA
Do you have one or two letters of denial in your possession? I'm not sure I caught that. It sounds like if you only have one letter of denial, then its just some miscommunication that needs to be cleared up. If you're confused, call and ask exactly what "patient safety and follow up care" means in the letter. :)   KEEP RECORDS  
(Hi/DoS/CW/GW) 335/320/243.5/174  (-91.5)(total lost) in 18-20 dependent on brand!
I'm more than half-way there! :) (68.5 pounds to go)
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