Secondary insurance decision

smileyjamie72
on 12/6/10 3:38 am, edited 12/6/10 3:39 am - Palmer, AK

Here is the e-mail from Dr. K's office

I contacted your insurance to see what the status of it was. I spoke to Marcy, she stated that the insurance has denied the authorization request. She couldn’t however give me a reason. She said that a letter would be on its way to us with an explanation. I was really hoping that it would get approved.

Do not worry, I will still be trying to get an approval, once I get the letter that states why I was denied
-Jamie

ETA: I also posted thi on the DS forum

RNY 2/26/2002                           DS 12/29/2011
HW 317                                     SW 263 BMI 45.1
SW 298                                     CW 192 BMI 32.9~60% EWL
LW 151 in 2003
TT 4/9/2003

Normal BMI 24.8 is my GOAL!!!

GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**

WASaBubbleButt
on 12/6/10 12:22 pm - Mexico

Revision on 12/06/06

Many times it's user error, someone forgot to send in everything and other times the ins co received everything but didn't realize it. It's likely something easily fixable.

Previously Midwesterngirl

The band got me to goal, the sleeve will keep me there.

See my blog for newbies: http://wasabubblebutt.blogspot.com/

smileyjamie72
on 12/8/10 6:41 am - Palmer, AK

DS on 12/29/11

That is what i was hoping too, but it looks like, besides the supervised diet that was "lost" because of the volumes of paperwork that needed to be reviewed.... I am thinking that I will need to repeat my EGD. Ya know, at this point, if I have to pay cash for that, I WILL!!!!

THANKS!!!
-Jamie

RNY 2/26/2002                           DS 12/29/2011
HW 317                                     SW 263 BMI 45.1
SW 298                                     CW 192 BMI 32.9~60% EWL
LW 151 in 2003
TT 4/9/2003

Normal BMI 24.8 is my GOAL!!!

GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**

C J
on 12/6/10 7:43 pm - Franklin, MA

Revision on 01/24/11

Been there done that... I was pursing ins. coverage for revision from band to VSG, after my first denial I filed a grievance w/the ins. co that was denied so my surgeon did a peer to peer that was denied, I field the appeal - denied, 2nd appeal - denied, external review-denied, independent review... denied

so frustrating!!!

You've got to stick with it - be persistent and give them as MUCH info as you can!!!

All the best to you,
CJ

smileyjamie72
on 12/8/10 6:42 am - Palmer, AK

DS on 12/29/11

Thank you, CJ!!! Frustrating is truely a GREAT word with you, me, and those insurance companies!!!!

Good LUCK!!!
-Jamie

RNY 2/26/2002                           DS 12/29/2011
HW 317                                     SW 263 BMI 45.1
SW 298                                     CW 192 BMI 32.9~60% EWL
LW 151 in 2003
TT 4/9/2003

Normal BMI 24.8 is my GOAL!!!

GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**

Secondary insurance decision

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Secondary insurance decision