Very Upset

After all the crap my insurance put me through. Telling me everyday that I had everything I needed for my approval and then I called them this evening and DENIED! I cried for a straight hour. I don't understand how they can tell me I have everything I need and THEN tell me I'm denied cause they want something that is impossible for me to get! I called the surgeon's office and she told me that she would call my insurance in the morning and talk to them cause they haven't even called her yet to tell her that a decision was made. I haven't been this upset over anything in years.

There have been several individuals that have been denied and then become approved.  I am sure that Dawn or whomever you spoke with at Dr. Morton's office will be able to find out what the reason is and maybe it is a simple correction.  Don't let this upset you too much, because many times a denial happens the first time and then to get an approval later, I know I was denied the first time, but two months later, I got approved.  I will keep you in my prayers!! Shelia

I've been working with Amy at Dr. Morton's office. She is a sweetheart.. My insurance is wanting documentation that I have been diagnosed with morbid obesity for the past 5 years. And there is no way I can get that. I have been considered morbidly obese since high school but I don't have documentation on being diagnosed with it until early last year

Can you go to your doctor's office from an office visit 5 yrs ago, did you have any physicals, cold, etc.  because every visit you go to, they write down your weight.  You can have them write a letter saying on "this date (5 yrs ago) this patient weighed xx lbs and was this tall"... that proves you were morbidly obese back then as well.  Do you have any er visits?  any doctors that have any medical records or office notes? chiropractors?  pursue all of these avenues... get a medical record copy of that office visit showing how much you weighed... ask them to write a letter. BTW, I knew BCBS asked for proof that went back several years as well...  I had an ER visit from 1999 where the ER doctor noted that I was severely obese... I remembered it, went to the hospital and got a copy of it... I proved to insurance that I had been overweight for their length of required time. And also, just to share something that got me once...  my records from a gynecologist said that the papsmear was difficult "due to obesity and guarding..."  That p*ssed me off so bad... I could have cried and that was in my early 20's...  I was overweight back that far and no one had ever called me obese... I don't know what triggered that memory...  but I remember how much that hurt and stung my heart... to be called obese by a doctor... 

Check with Amy, because as long as your doctor has records of your weight for the past five years, you should be able to use that.  I know each time I go to the doctor, they always weigh me, numbers don't lie.  To me, I could be wrong, but that should be enough documentation to prove the morbid obesity, a letter from him could not help either.  I think this should be fairly easy to correct, dot those i's and cross those t's and you should be approved soon. Keep your head up!! Shelia

I know its a terrible and angered feeling... I got denied too... I met all criteria... I submitted all the records, required documents, jumped through their hoops like an elephant at the circus... still DENIED.  Insurance companies make interest money off of your employer's funds.  They want to hold on to that money as long as they possibly can.  They will deny services for as long as they can.  Its a stall tactic.  They will deny it but hey we all know its about the BOTTOM DOLLAR... the mighty dollar. Hang in there.  They want you to give up, not come back, and they will just keep drawing interest.  Do not give up. Fight.  Call them back, everyday if you have to.  I called my insurance company like 40 times in 30 days.  NO LIE !  One lady tried to tell me not to call back.  Show them you are not going away.  Ask what they need.  Provide it.  Fight for it....  Let me tell you, in the end you will appreciate your surgery much more as you had to fight for it tooth and nail... and it will show you whether or not its what you really want...  the disappointment you felt when you cried a solid hour... that shows me that you really want this badly......If you don't continue to pursue it, you will always regret it....

I want this more than anything. I have already made alot of changes in my lifestyle to get ready for it. I hate insurance companies. I mean they are already paying out the butt for all the freaking doctors i see and medicine I take. I have PCOS, high bloodpressure, heart palpatations, and now some bloodwork came back from my Gyno from last week and they called me yesterday telling me that all levels of cholesterol were high and I needed to see my PCP. So they are shelling out money for all this other stuff... why not pay this so they don't have to pay those anymore? I'm only 25 years old. I have 2 kids! I don't need to fall apart and die early. There is too much for me to live for. Too much runs in my family for me to stay like this. My mom isn't even 50 yet and had a stroke last year.

Pretty simple.. go to every doctor, etc that has record of your weight and get it for the past 5 years or so (or whatever is required).  The weight to height ratio will be more than enough to prove morbid obesity.  No comments in your record are really needed as long as the weight/height measures up.  Hang in there.  I know what its like to be turned down.  I wasnt turned down by my insurance, but by my surgeon for another reason.  You gotta keep chuggin' along and just try to make everyone happy.  Ill be praying for you. Rob

I had all my weights from the last 5 years. Apparently that wasn't enough for them

Laura, If you have pictures of you at this time sometimes this works, it did for me.  Good Luck. Beth