Denied!!!!!

Sexyvt123
on 7/7/11 7:22 am
I am so mad right now I can't even begin to go into details.  I called my insurance for an update and they told me it was denied because of no proof of exercise and diet.  14 days and you now decide this.  I sent all of that information and they claim to not have it?  I'm so mad right now that I need to go get some fresh air. 

FYI

Before I go I will tell you this... I just fax 143 pages of my pre op, post op, medical records **** everything under the moon to BCBS of IL because this is bull****  I just dint understand how some insurance make things easy and some make things hard.  I will fight this the end because I refuse to pay all this money when the month and be able to use my benefits that I'm paying for. 

Hislady
on 7/7/11 8:21 am - Vancouver, WA
You go girl!!
(deactivated member)
on 7/7/11 2:29 pm - San Jose, CA
Do NOT fax it - FedEx it, with signature required.
Frankie
on 7/7/11 11:41 pm - NY
Good morning, Damn I wasn't expecting that!  Fight their asses!  Make a copy and either FedEx or UPS it with signature required so those *******s can't say they didn't receive it.  You deserve your revision.

Frankie
                    
Sexyvt123
on 7/8/11 7:12 am
Hi Guys

Im doing much better today and I am calm and back to business.  One of the nice reps that was trying to help me yesterday called me this morning and told me that the case was not fully closed and that they did receive all 146 pages.  She told me that she will put a note in today to have them review the paperwork again.  One lady that I spoke to yesterday must have felt so bad and guilty that she sent them another note after I got off the phone with her yesterday.  She told me she can not gurentee anything but she will try.  Deep down inside I truly believe that no one reviewed my records and that they put denied because they ran out of time.  Now I have to wait another 14 days so they can review again.  Why do people not like to do their jobs?  This health industry in this country makes me sick.  It make me irate that the fate of my health depends on some random person.  I will FedEx my paper work in the morning as well just so I dont hear any other bull**** when the time comes. 

Band to DS
on 7/8/11 9:57 am, edited 2/4/12 3:54 am
Unfortunately, I had to delete this post due to privacy concerns.

Got a lap band in 2008. Tried hard, but didn't lose much weight & developed swallowing problems. Fought my insurance company for almost a year & finally had a band to DS revision on 5/11/12. Have now lost 125 pounds. Yay!

Sexyvt123
on 7/9/11 6:56 am
Hi Shelli

Yes it is a requirement and I did provide them with all that informationg.  They simply did not read or review my paper work.  I believe they waited to long to the deadline and just put denied because they ran out of time. 

CindyLyn
on 7/8/11 1:50 pm - Evadale, TX
This is the same thing Federal BCBS is doing to me.  They recieved all of my required paper work and test.  On the day they said they would give me a answer I got a letter stating I need to prove Diet and exercise for the past year...  How the heck do you document that.  I  mean I could sit down and write a bunch of stuff down but that could be disputed also.   I faxed them everything I could get my hands on about 3 days ago... What is up with Blue Cross.... I was approved in 2 days for my first surgery.
Girl I am praying for you everyday (and myself also).  This band is empty but I am still choking and vomiting and the port sight is killing me.  It hurts to do anything the least pit strenuous!!
We will get through this and get our dates soon... I just know it!!

Revision from Lap Band to Gastric Sleeve.  August 16, 2011

Band to DS
on 7/9/11 12:22 am, edited 2/4/12 3:55 am
Unfortunately, I had to delete this post due to privacy concerns.

Got a lap band in 2008. Tried hard, but didn't lose much weight & developed swallowing problems. Fought my insurance company for almost a year & finally had a band to DS revision on 5/11/12. Have now lost 125 pounds. Yay!

Sexyvt123
on 7/9/11 6:59 am
They  make me sick.  I thought the six month supervised diet would be enough.  I dont know what else they would possibly need after that.  I mean I was going to the gym here and there but not everyday.  Im already getting the print out from my gym to proof I went to the gym.  I will send that out next week and see what they say as well. 

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