Denied as experimental

Breezin J
on 8/14/08 2:39 am - Chandler, AZ
I received verbal notification from my surgeon's office yesterday that Anthem BCBS (CA) has denied my precertification for VSG because it is considered "experimental".  I'm so unhappy - but want to appeal.  I read a post on here from someone with BCBS of GA that was approved for the VSG the first time out.  Any idea what they did differently?
Annie C.
on 8/14/08 10:06 am - North Texas, TX
Darn, that's my insurance! Well, if they deny, I will appeal. I do not want the lap band and I recently found out I am anemic. If I have the RNY, my anemia will only get worse. How long did it take for you to get a reply from them?
(deactivated member)
on 8/14/08 4:44 pm - sunny, CA
Breezin J
on 8/15/08 1:16 pm - Chandler, AZ

The Dr's office filed the paperwork on the 7th and the insurance co. called the Dr's office on the 13th that VSG was experimental.  The Dr's office told me she'll call as soon as she gets a formal letter.  I called Anthem BCBS and they told me it was still in review.  I will appeal though, I feel like VSG is the best and only surgical choice for me.

(deactivated member)
on 8/21/08 5:18 pm - sunny, CA
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