Sometimes they are hard to get ahold of bc they are so busy but keep trying! My process took forever. Not because of OL but because of insurance appeal and then my external appeal. It was worth the wait though. Why is your insurance denying you?

Probably not.. The Surgeoun will need to submit to the insurance company for approval.. It sounds like you have been through a lot..so it shouldn't be too bad.

Written reason is odd...... first they comment that band over bypass is experimental (not a proven procedure)....  then they specifically state that my BMI is too low  37.5 ... however they go on to stte that  they will also consider 35 with co morbidities, they also stated the application for approval did not contain 5 years of weight history.... Well, it contained almost 8 years!

I am still diabetic  (on two types of injections and oral meds)  still cholestrerol problems (back on simistatin) and still HBP  (back on lisopril)....\

That said, the surgeon's office immediately prepared a cover letter stating all of the above.   

SoI'm gathering info about attorneys just in case.

After several years of jumping through hoops, classes, multiple surgical consults, a battery of test, etc, I finally received a referral letter from my PCP for DS Surgery at University of Chicago.

Is this all I need? Does this mean I should be doing the happy dance and that my surgery is going to be covered? Did I finally reach the light at the end of the tunnel?

I have BCBC Illinois Blue Advantage HMO. My medical group is Hammond Clinic.

Thanks for any insight.

 
Why are they denying you?  What is their written reason?