Why can't I get a straight answer?

Elizabeth M.
on 4/16/08 5:40 am, edited 4/16/08 5:58 am - Smithfield, OH
Hi all, I had a Vertial Banded Gastroplasty 9 yrs ago. I initially lost 99 lbs and over the last 9 yrs have put 75 back on. I have contacted a surgeon about a revision and had my initial visit with him. I met with the Nurse that tells you about what insurances require for surgery apporval. She told me to call my insurance company to see if I have an excluetion for WLS.   When I called my insurance company a very nice lady read me the information over the phone she told me that I must have at least 3 months of physician supervised diet and exercise to meet the critria for WLS so I thought GREAT I can do that peace of cake!  So I asked her to print it out and fax it to me. She told me she wasn't able to do that but that I could go directly to their website and in the search box type in Weight loss surgery and it would bring up all the information I needed. So I went to the site and seached every page for a search box, I never found one!  I did find a way to email my insurance company with questions. So I sent them an email expaining completely why I was emailing. That I had been told by one of their representative to go to the site and enter Weight Loss Surgery in to the "Search Box"  but was unable to find any "Search Box" on the website. I got back and email that said "they could not answer my question because I had already called and spoke to someone about it". What is up with that?   So I emailed them again and told them they had not answered my question that I had called prior to going to the website to search. I receive a responce that "someone would be calling me about the matter"...that was 3 wks ago and still no one has called. So I called my insurance company again and asked them again what the criteria was for WLS. This time they gave me a different phone number told me to call my doctor and have them call to find out.  So I call my surgeon's office and they said that my insurance is givng me the run around and I should just follow the Medicare guide lines because most insurance companies follow those for criteria. All I want to know is how what is the cirtieia I have to meet! What is so diffucult about that question? Can anyone tell me what hoops I need to jump through to find out? Thanks, Tedi

Cheryl Gebbie
on 4/16/08 6:02 am - Knoxville, TN
What insurance company do you have ?
joan-the incredible
shrinking

on 4/16/08 12:19 pm - 128 Belt, MA
Is your insurer through an employer?   You can go to HR and ask them to assist you. You could also file a complaint via your state insurance bureau. Good luck.
Nancy K.
on 4/18/08 2:18 pm - Joliet, IL
I always find it works best when you are getting the run around to ask for a supervisor and keep going up from there. Remember something... EVERYONE has a boss that they answer to. Call back and demand answers and also go thru your HR person if necessary. Good Luck. I too am a VBG revision. I am having the DS.
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