WHY?

butterjoy
on 7/31/08 7:26 am - Elkview, WV

I GOT A LETTER FROM MY INSURANCE. I WAS DENIED. IT SAYS THEY DENIED MY REQUEST BECAUSE: BASED UPON CLINICAL INFORMATION RECEIVED, MEDICAL NECESSITY HAS NOT BEEN ESTABLISHED ACCORDING TO PEIA CRITERIA.

I DON'T UNDERSTAND WHY THEY SAY IT WAS NOT "MEDICAL NECESSITY" WHEN ALL THEY HAVE TO DO IS READ ALL MY FILES. CAN SOMEONE EXPLAIN?

THANKS
JOY

* Our family is a circle of love and strength. With every birth and every union, the circle grows. Every joy shared adds more love. Every obstacle faced together makes the circle stronger. The love of a family is life's greatest blessing.
I have reached my goal!

Crystal_girlost
on 7/31/08 8:56 am - WV

REALIZE Band on 09/24/08

I am so sorry to hear this. It is the nightmare of all pre ops. I would call Dr Shin's office and see if they can give any assistance.

Crystal

First fill 11/4/08 3cc's Second fill 12/19/08 2cc's
Third appt 1/27/09 rescheduled
Third fill 3/24/09 1 cc= Total 6cc's

butterjoy
on 7/31/08 10:26 am - Elkview, WV

RNY on 11/03/08

I AM SITTING HERE TRYING HARD NOT TO CRY. IT IS WONDERFUL TO READ ENCOURAGING WORDS. I WILL GO TO THE OFFICE TOMORROW TO SEE WHAT I CAN DO. I FIGURE THEY WILL MAKE AN APPOINTMENT FOR ME TO SEE THE LADY THAT HANDLES THE REQUESTS. I WILL LET YOU KNOW WHAT I FIND OUT. THANK YOU SO MUCH FOR BEING HERE AND LISTENING TO ME.

ALWAYS,
JOY

* Our family is a circle of love and strength. With every birth and every union, the circle grows. Every joy shared adds more love. Every obstacle faced together makes the circle stronger. The love of a family is life's greatest blessing.
I have reached my goal!

willa
on 7/31/08 12:27 pm - southern, OH

Lap Band on 07/18/07

remember anything WORTH HAVING is WORTH FIGHTING for.... so dont give up and keep your head on so that you dont loose your goal......

I think I have heard PEIA is one of the toughest companies to get approval for but they do finally get it thru their heads that it is needed....

wvteacher
on 7/31/08 3:53 pm

I hope your visit to the dr. starts things in a better direction for you. Good Luck! *hugs*

butterjoy
on 7/31/08 9:47 pm - Elkview, WV

RNY on 11/03/08

I WANT TO THANK EVERYONE FOR HELPING ME. I COULD NOT SLEEP LAST NIGHT. MY MIND WAS GOING IN CIRCLES TRYING TO FIGURE OUT WHAT TO DO. I WILL MAKE A APPOINTMENT WITH THE BARIATRIC SURGEON'S OFFICE. AS SOON AS I FIND OUT WHAT THEY SAY, I WILL LET YOU KNOW.

THANKS,
JOY

* Our family is a circle of love and strength. With every birth and every union, the circle grows. Every joy shared adds more love. Every obstacle faced together makes the circle stronger. The love of a family is life's greatest blessing.
I have reached my goal!

Cira S.
on 8/1/08 1:11 pm - Charles Town , WV

RNY on 03/06/07

Dear Joy,

You work on getting an appeal and make sure your dr's office finds out everything that is needed to resubmit. I am sorry that this is happening to you but like the others said. Stay focused do what you have to do to get this approved.

Please keep us posted and don't give up!

((((((((hugs))))))))))

I am who I am and accept my feelings wholeheartedly.
Those that mind don't matter, and those that matter don't mind.
Cira 249/144.0 current/goal 154/ 5'3" 10 lbs below my Dr's goal
100Cira-1.jpg picture by negra266

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