Approval for my daughter!

I posted a while back that my daughter was denied on March 9th.  We filed an appeal 3 days later and just found out today the appeal have been overturned and she's been approved to have RNY!!!!!  I am so happy for her.  Waitng to hear a surgery date now!

For anyone discouraged with insurance, if you have met the requirements spelled out in your clinical bulletin and you are denied, don't give up!!  It is worth fighting for.  I was denied, and approved on appeal.  My daughter was denied, and now she's been approved on appeal.  A little setback and very discouraging, but don't give up, they will approve you if you have crossed all your T's and dotted your I's as long as you have met the requirements they spell out for you.

Can't wait for my daughter to enjoy the same type of journey I had this past year!

Nan

That is great! I had seen your previous post and was hoping she would get good news :)

Thanks for the reply!  She is very excited and I'm so happy the appeal went through.  Yesterday she found out her surgery date is May 10th.

was this with aetna?  Your post gave me hope, I have been very depressed, especailly tomite  I am so miserable.  I did ask for the peer review, but after reading this I am going to call aetna and figure out the appeal process.

thanks fr the encouragement

Yes, this was with Aetna.  What was the reason they gave you for being denied?  What was the exact wording in the denial letter.  For my daughter she was denid for lack of proof of obesity for the past two years.  She clearly met the requirements of being obese for 4 years, so I sent in the Dr visits since 2007 (she had visist in 2007, 2008, 2009, 2010) showing a BMI of over 40 which is what the require with no co-morbidies. 

Maybe if you share with me what you were denied for, I can help you with your appeal.  Don't give up!!  It may be a delay, but don't give up.  A lot of times it is just knowing what they want and what information you are missing.  Once you provide them that ihformation the denial can be overturned.