Denied, but Resubmitting

Kelly S
on 6/8/05 8:59 pm - Some City, PA
Hi all, I've appealed my request for RNY with Health Assurance three times since March. My BMI was 38.6 (in November 2004). Although I have co-morbids that are defined in their criteria to be used to determine medical necessity for Gastric Bypass, I was denied because my co-morbids are not 'life threatening' enough (this doesn't make sense to me...). Anyways, My BMI is now 40.6. My surgeon suggested that we resubmit. I want this so bad for so many reasons and being denied the chance to become healthy just made me feel like I'm being kicked while I'm down. I will now keep my fingers crossed and hope that there are no other reasons they can deny me. I am because we're up against a major deadline. Health Assurance will no longer cover Gastric Bypass after our policy renews (August 1st). I just have a bad feeling that they will drag this out to avoid having to pay.... Discouraged, but not giving up.... Thanks for listening and good luck to all of you who may be going through the same thing. Kelly
...Platinum...
on 6/9/05 12:19 pm - Somewhere in, DC
Hi Kelly, I'm keeping my fingers crossed for you. I think it's a good idea to resubmit. It's like starting over fresh. I was denied and exhausted all of my appeals. I did my 6 month diet and resubmitted. It was approved. Keep going! Do not give up!!!!!!! Court
Kelly S
on 6/9/05 8:41 pm - Some City, PA
Hi Court, First of all, congratulations on your upcoming surgery! I am hoping so bad to get approval this time around, but my insurance has certainly been stubborn.... Hopefully, since my BMI is now 40+, I'll have a slightly better chance. Thank you for your kind words and encouragement. Have a nice day, Kelly
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