Denied!!

I just got off the phone with my insurance company and found out that they denied me!  I don't know all the details yet except that it said that medical necessity had not been established.  Geez, my starting BMI was 47!  Isn't that bad enough! She told me that the letter they sent out today will be specific about what else they need and how to appeal it.  Right now I either want to cry or swear or both!

Sheryl

Sheryl,
I am sorry to hear that. Don't give up the good fight! I'm sure your insurance has an appeal process, so its important to stay focused on your goal of getting WLS, so get those ducks in a row while you are waiting for the next steps. I know it can be tough, but it is so worth it!

I won't give up, that's for sure.  I'm trying to tell myself, "a year from now this won't matter", but I feel like I've been waiting forever.  I've been doing a 6 month (well 7 now), medically supervised diet and I'm tired of it.  Thanks for the encouragement.
Sheryl

Don't fret too much I was denied 3 times before getting approved. Each time it was because of some technicality that wasn't written the way they wanted it or not enough info that they wanted. Insurance companies are very knit picky, maybe to make sure we are serious about it but anyway hang in there and see just what they want when you get your letter. I'm sure the surgeon's office has dealt with these things before!

Three times?  That's harsh.  What kills me is that until July 1st, when we switched to this plan, they only required a 5 year history of high bmi and they were a breeze to get an approval from.  Suddenly they tighten their belts and seem like they're are looking for reasons to deny you.

thanks for the encouragement.
Sheryl

oOOoO my goodness that stinks. That’s crazy you have done the diet and your bmi is higher then 40. Whats the deal? What insurance do you have? Appeal Appeal Appeal! You will get through this!

Sheryl,

I am sorry you got denied but do not get discouraged.  I know that you are sick of the pre-op diet but you have done very well with it.  46lbs is a great weight loss.  Good job whatever you are doing is working.

I don't know if you feel comfortable sharing who your insurance company is but sometimes going to the main board and posting who has that insurance other people can help you or give you advice on how they got approved by the same insurance company. 

Sheryl~

I'm so sorry you got denied! Don't let it get you down...just keep at it and it will come eventually - hopefully soon! *hugs*

Sheryl,

Can't offer much - just wanted to let you know that I feel for you and hope you get it all straightened out soon.  Keep on the folks at Dr. S.'s office - they can get around a lot of stuff, but sometimes they are busy and stuff get's a little put off.  (Probably not telling you anything you don't already know).  NOT to say anything bad about any of them - they are great - but you know how it goes.

Best of luck and hope it's resolved soon!
the other amy

Mine originally came back as denied.  Dr Srikanths office already had the appeal and more documentation ready and sent out by the time I called their office.  Kaye told me to be patient and wait a week... but 4 days later I got the approval.

hang in there Sheryl... it might still all be okay.

Much Love