Going to Court to Get approval.

I am going to court on August 2 to talk to a judge to see if he will approve this surgey. I have Tenncare and this the only way that I can have the surgery! Please pray for me and that they will decide to let me have the surgery and if anyone has any suggestions that will help please let me know.

tenncare is very cut and dry on WLS approval. Basically, if you meet their qualifications, you will be approved. Are you 100 lbs overweight? Is your BMI over 40? Do you have a comorbidity? (diabetes, sleep apnea, etc) If you say yes, then you qualify... if the above is true for you, could it be that they didnt have all the paperwork needed for an approval? If you dont have one yet, GET A CASE MANAGER FROM TENNCARE!!!! Good luck!!! Rachel 270/198

replying again here - is your surgeon in network for tenncare? if not, they may require you to go to an in-network surgeon. it will be a fight to use an out of network surgeon. i checked your profile and i see your BMI so i know that qualifies, but it doesnt mention comorbidities... im really feeling your frustration right now... this is scary enough to go through without having to deal with crap from the insurance company!

no doubt Case managment is the best way to go with TNCare. My case manager has been an absolute godsend. Of course my BMI was what was causing a problem with me finding a surgeon (it was so high local surgeons wouldn't touch me) and the only co morbids.. that I have are sleep apnea and asthma. But my case manager found my surgeon for me and even helped me with arranging transportation to clarksville (aprox. 4hrs away) for my appts and for my surgery date. Unfortunately, if things go well the rest of this month she will be closing my case but it has been almost a yr since she first started on it. I wish you the best on this. *huggles*