Medicaid Denial....

OK. Im not upset but I just found out that my surgeons office was notified today that I have been denied by Medicaid. They have the paperwork and the "codes" but so far I have not received any letters in the mail concerning this. Does ANYONE have a similar experience? What were the reasons for your denial? I am assuming that it is a small thing that can be fixed but it still scares the crap out of me to get this far and be told "no". I know people dont usually respond to my posts much but I sure could use some words of encouragement right about now.

Hello RM Well, I can not help you with the Medicaid problems, since I was a self pay person, but since you feel like folks don't respond to your post, ,,, maybe they are like me and have no answers for you. I try not to answer people's post unless I can't offer some help, I know I don't know it all so I allow others to step in. I sometimes also do not get many answers, but I still ask when I need to , so you keep asking away, and when you ask something I know I will reply Allison

hi RM, i was denied at first by medicaid too. for me, it was because my documented weight history wasnt enough. i needed six consecutive months of weigh ins and diet. when i started the supervised diet after denial i also went to my local dietician each month right after my doctor appt. and conslted with her too for back up. your denial might only be a missed signature by the doctor or some info that wasnt documented. medicaid is very very picky. i hope you get your approval soon. adrienne p.s. i never recieved the denial in the mail. i guess my doctor was the only one to recieve it

Hi RM, I am not using Medicaid, but have also heard that they are very picky. ECU told us at orientation that if you were on Medicaid, that the doctor had to have his notes written in a particular way or they would deny. That might be worth checking out, too. They gave out a sheet for folks to take to their PCPs, so they'd know exactly how to phrase their notes...let me know if you'd like me to track it down for you. I also remember them saying that if you went for the 6 mo. appts and talked about ANYTHING other than weight loss, that they would reject that part of the packet. I can't speak from experience, but it all sounded very complicated and worrisome. I can understand your feelings in that kind of situation. But don't give up. I will keep you in my thoughts...and with everyone here on your side, things are bound to come out good for you in the end. Best to you, Lisa

Hey R.M., I know I've responded to your posts before and I think that some people don't know what to say, Like Alison wrote. We all have our challenges, some are more strenuous then others. Life is unfair and it follows it's own course. I encourage you to fight the appeal and I have confidence you'll get right to the bottom of the reason why you were denied. It could be something as simple as a keying error. I encourage you to stay focused, keep fighting, because it is worth it in the end. You will eventually get approved and become a loser too. Good Luck. Keep your head up. Jennifer

Well, as long as you did everything you shouldn't worry. I did every thing the medical reviewer just did not look hard enough to find the documentation. I was denied 1st for things like A1c levels well I am a diabetic so you know they checked and documented my A1c's I have hypertension so you know they documented my blood pressure readings . . . they also wanted a diet plan well I had to provide that because my PA did not give enough specifics in her documentation. The frustrating part is being denied and know that I done everything to the letter. Don't give up! You will get approved. Phenom 322/286/160