"Mad as Hell"

I 
UMR 


 I am very mad right now. My insurance had advised me when I called that gastric bypass was a covered benefit  in May 09. So I scheduled and went a wls seminar on June 18th.
Today my surgeons office advised me that they submitted info to see if wls is a covered benefit now they are saying that my insurance stated that they have an exclusion in the policy.  Why ? Why? Why?

I have talked to surgeons office, insurance and my ,Hr department . I  want to know why I was lied too I don't think that is fair to get someone's hope's up and then crushed.I am pissed off. I have called several time and the reps on the benefit line stated that it was covered . Now all of a sudden it is not  I want answers I am going to fight this .



Any help would be appreciated

Check it out with www.obesitylaw.com. Insurance co's can't change horses in the middle of the stream without giving advance notice to it 's policy holders. Good luck!
Holly

You have every right to be mad,That's not cool of them too do.You have the right attitude don't let them get this away with that.Fight them and keep fighting until you get an answer.

Thank you girl believe me I am

I am currently dealing with a similar issue. My insurance company gave me the guidelines necessary for approval over the phone back in January. My surgeons office was also given the same guidelines. After everything was completed and submitted to insurance, they are denied me stating that my husbands employer has a different set of guidelines whi*****lude having 2 co morbid conditions that I do not and have never had. I was never once told that there was a separate policy until I was denied. To make matters worse, when my surgeons office called to find out what was going on, they told her that I was denied because my psych evaluation was missing, not because of not having documentation of the co-morbid conditions. So I resubmit and was denied again--FOR THE SAME THING!. So I'm screwed. I can't afford to go through Obesity Law, so I guess I have to appeal.

If you called the insurance and just asked if WLS was covered, they gave you a generic answer.  You have to be specific and ask Does my policy with this ID # cover WLS.   That is how tricky insurance companies can be

My insurance company wouldn't even talk to me without me giving them my group number and ID number---And they STILL didn't give me correct information.

Stacy if you have a name, date you spoke to them and time, you can possibly file an appeal.  Or if you want to pursue it further contact Kelly and Walter Lindstrom at www.obesitylaw.com and see if they can help

I filed my appeal yesterday. I did contact obesitylaw.com. They just got back to me but I'm not sure that I can afford a lawyer....

I just talked to UMR yesterday to see if VSG is covered.  They told me that the only things they saw under bariatric surgery were LapBand and Gastric Bypass.