Hi,

You seem very organized, so I'm going to jump start from you if you don't mind.  First question:  Who & Where is Miss Missy?   Second:  So you had four consecutive months seeing all three each month Primary Care appointment,  Nutritionist appointment, and EP (what's EP).  What letters did you have the write? Can I get a copy?.  I'm pretty sure my specialist who deals with my stomach issues would help too.  How did you give them exact weights for the last 24 months... Did you give an educated guess?  Did you need doctors records to verify?

I want to use my time an co-payments wisely?  Meeting insurance criteria can be frustrating...  After the insurance paid, did you have any balance owing?

Thank you,    trustJesus

I didn't have to do an appeal, so I can't help you.  I'm sorry!  I just wanted to acknowledge you though.  I hope you find help!  Can your surgeon's office help you?  That is who usually helps with the appeals. 

I am new to OH and have read that I need to first be accepted for WLS through my insurance before I start the 6 month required visits to see the nutritionist.  Can anyone tell me if this is true? I have called my ins., (BC/BS), and asked them if they cover gastric bypass surgery and they said it is covered and then they went into my requirements, out of pocket, etc.

Any help you can send me would be greatly appreciated.  I already know about the six months of doctor visits, etc.  But, am confused on the first step.

Thanks!

Sorry you got denied.  I have read other post of people with the same issues with their insurance co.  You might want to post this question on the revision forum as well.

Hopefully they will approval after the peer to peer.  Keep us posted.

Hi chinamomma I have fepblue and was also approved for the lap band removal but denied the RNY.  My surgeon is also having a peer to peer review this Thursday.  From your ticker I'm assuming your peer to peer resulted in approval?

T