Insurance Denied!!! X-Post
Ok so I got the call from the surgeons office that I was denied by my insurance because it was a exclusions on the employers part I was trying to stay so positive and thinking oh I will get approved the first time I know I cant give up but I need some advice on my next step...TIA
Nikki
Find me on facebook~ Nikki White-Heflin
"I'm selfish, impatient and a little insecure. I make mistakes, I am out of control and at times hard to handle. But if you can't handle me at my worst, then you sure as hell don't deserve me at my best." - Marilyn Monroe
My
is Rebecca Finkenbinder
Highest Weight/Day before Surgery/Starting Weight/Current/Goal
324/321/316/224/150
Lost 100 pounds November 19, 2010
First Appointment (4.3.2009), Psych Evaluation (4.13.2009), Insurance Approval (5.27.2009), Surgery Date Cancelled, New Surgeon Appointment (8.11.2009), New Insurance Approval (12.1.2009), Surgery Date (01.20.2010)
WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Less weight regain, No dumping, No fills, Eat normal sized meals, Won't regain weight, No revisions, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured.
Find me on facebook~ Nikki White-Heflin
"I'm selfish, impatient and a little insecure. I make mistakes, I am out of control and at times hard to handle. But if you can't handle me at my worst, then you sure as hell don't deserve me at my best." - Marilyn Monroe
My
is Rebecca FinkenbinderHighest Weight/Day before Surgery/Starting Weight/Current/Goal
324/321/316/224/150
Lost 100 pounds November 19, 2010
First Appointment (4.3.2009), Psych Evaluation (4.13.2009), Insurance Approval (5.27.2009), Surgery Date Cancelled, New Surgeon Appointment (8.11.2009), New Insurance Approval (12.1.2009), Surgery Date (01.20.2010)WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Less weight regain, No dumping, No fills, Eat normal sized meals, Won't regain weight, No revisions, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured.
I'm so sorry to hear about that. Do you have an HMO or a PPO? If you can write an appeal I'd do it. I'm not sure what the exclusions means though... it doesn't sound like something easy to get around... Maybe you can buy additional private insurance if it looks like there is no way your employers insurance will ever cover it... You might want to talk to a lawyer too if you can afford to. I've heard letters from lawyers to insurance can really get things moving. Good luck!
damn that sucks. honestly i dont think there is anything around an exclusion by your employer. They've basically said to the insurance, we'll buy this package for our employees and they probably saved a BUNDLE by pre excluding WLS as an option for any employee.
Unfortunately its not like a regular denial letter from insurance...this situation is pretty much out of their hands as well.
I recomment getting in touch with your companies HR to confirm the exclusion...its really all in the employers hands now. Sorry hun
private insurance may be the way to go at this point.
Unfortunately its not like a regular denial letter from insurance...this situation is pretty much out of their hands as well.
I recomment getting in touch with your companies HR to confirm the exclusion...its really all in the employers hands now. Sorry hun
private insurance may be the way to go at this point.
SW-236/GW 125- pre pregnancy weight-133 / current weight- 123!!
Defeated PCOS with the help of my RNY & despite being told I couldnt have kids, i am a proud mommy to Bella Rosa =)
Defeated PCOS with the help of my RNY & despite being told I couldnt have kids, i am a proud mommy to Bella Rosa =)
I also have Missouri Medicaid but it is what they call a spend down so I have to pay like $1500.00 to use it the Dr. office sent it in to them today so maybe I will get somewhere with them wish me luck....
Nikki
Find me on facebook~ Nikki White-Heflin
"I'm selfish, impatient and a little insecure. I make mistakes, I am out of control and at times hard to handle. But if you can't handle me at my worst, then you sure as hell don't deserve me at my best." - Marilyn Monroe
My is Rebecca Finkenbinder
Highest Weight/Day before Surgery/Starting Weight/Current/Goal
324/321/316/224/150
Lost 100 pounds November 19, 2010
First Appointment (4.3.2009), Psych Evaluation (4.13.2009), Insurance Approval (5.27.2009), Surgery Date Cancelled, New Surgeon Appointment (8.11.2009), New Insurance Approval (12.1.2009), Surgery Date (01.20.2010)
WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Less weight regain, No dumping, No fills, Eat normal sized meals, Won't regain weight, No revisions, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured.
Find me on facebook~ Nikki White-Heflin
"I'm selfish, impatient and a little insecure. I make mistakes, I am out of control and at times hard to handle. But if you can't handle me at my worst, then you sure as hell don't deserve me at my best." - Marilyn Monroe
My
is Rebecca FinkenbinderHighest Weight/Day before Surgery/Starting Weight/Current/Goal
324/321/316/224/150
Lost 100 pounds November 19, 2010
First Appointment (4.3.2009), Psych Evaluation (4.13.2009), Insurance Approval (5.27.2009), Surgery Date Cancelled, New Surgeon Appointment (8.11.2009), New Insurance Approval (12.1.2009), Surgery Date (01.20.2010)WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Less weight regain, No dumping, No fills, Eat normal sized meals, Won't regain weight, No revisions, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured.
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