booo hoooo - - denied
BC denied me. They said I had not lost 10% of my body weight. And, do you know how much I have lost? 9.75%. I am 3.6 pounds away from the goal. And, she also said that they needed an attending physician other than the surgeon to provide in writing information that I have attempted weight loss within the past 2 years! Hello? Did they not read MY records? Whose records were they reviewing? Its all through my records, and my gyn and pcp both wrote letters describing the diets I have tried since 2004.
(sigh)
Anyway, an appeal is being done so we will just keep on calling them every day. I am not giving up. If I have to, I'm going to write a grievance, which is the next step after the appeal.
There is some light in the tunnel. My doctors office called BC and the two year weight loss attempt will not apply because I have graduated from the mandatory weight loss program that my employer requires. It was twelve weeks long; I finished a few weeks ago. And, they aren't supposed to apply the 10% weight loss rule, but I am going to get weighed tomorrow at the PCPs office. I hope that if I lost 9.75% that they will round it up to 10.
I hope you don't have a hard time getting approval. It was disappointing when the lady at BC broke the news. That's when the anger rose up in my gut and I was just mad from that point on. I finally calmed down after talking to the docs office.
Hi Melinda, I am sorry to hear that they denied you. But don't quit now, keep fighting. I didn't have problems with the insurance companies, mine was denials from 11 surgeons. I ended up having diabeties and leukemia, and a surgeon approved to do my surgery as long as I had a great report from my Oncologist. I am 7.5 months out now and lost 102 lbs so far. Don't give up on your dream, I didn't considering what all I had to go thru. It may not be tomorrow, or next week, but it will happen. Believe in that.
May God travel with you on this journey, Love Kathy
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