Bariatric Buddy
not approved
Elizabeth, do not despair. This is just a hurdle that insurance placed in your path. Work with the surgical team on an appeal. They must see enough comorbidities that you would benefit from surgery. Insurance is doing what they can to save money. Sometimes an appeal is all that is needed.
Consider writing a letter to insurance in addition to the appeal letter from your surgeon's office. List your concerns, co morbidities, family history, the potential cost savings by stopping some or all of your health issues in their tracks.
This is not the end of your journey, just another speed bump placed in your path. Steam roll over these bumps my friend. Hugs
Consider writing a letter to insurance in addition to the appeal letter from your surgeon's office. List your concerns, co morbidities, family history, the potential cost savings by stopping some or all of your health issues in their tracks.
This is not the end of your journey, just another speed bump placed in your path. Steam roll over these bumps my friend. Hugs
OH Support Group Leader
Come visit us at the bariatric buddy group http://www.obesityhelp.com/group/bariatricbuddy/welcome
Come visit us at the bariatric buddy group http://www.obesityhelp.com/group/bariatricbuddy/welcome
I have major issue in family history heart problems on my father side {my dad age 54/aunt started in her 40 and died at 56/grandpa stated in his 50 died at 56} all had quad bypass.
I already have high cholesterol and have since i was 20.
Thank you for your advice I think I will write down some thing to put in the appeal when I go talk with the DR.
I already have high cholesterol and have since i was 20.
Thank you for your advice I think I will write down some thing to put in the appeal when I go talk with the DR.
Great advice, Kathy.
Elizabeth, your surgeon's office can help write the letter of appeal. Often times, the insurance company doesn't have everything they need to make a fully informed decision. They may be making a decision based upon only some information.
I was lucky; my insurance company (Anthem BCBS) approved my claim within 3 days. But I spoke with two different people in the doctor's office who had to write letters of appeal. They were both successful and I'm sure you will be as well.
Good luck to you!
Elizabeth, your surgeon's office can help write the letter of appeal. Often times, the insurance company doesn't have everything they need to make a fully informed decision. They may be making a decision based upon only some information.
I was lucky; my insurance company (Anthem BCBS) approved my claim within 3 days. But I spoke with two different people in the doctor's office who had to write letters of appeal. They were both successful and I'm sure you will be as well.
Good luck to you!
Welcome Denver Guy! Nice to have you here in our group. Not many men post here, and it is nice to see you doing so. The guys seem to come and go and never really stay.. Hope you will hang around! I am in Colorado too..small world!
Patrece
JUST DO THE NEXT RIGHT THING!
Obesity Help Support Group Leader & Coach
http://www.obesityhelp.com/group/bariatricbuddy
Lost 114 lbs. working on getting rid of a recent 10 lb regain...and WILL succeed!
Hey Elizabeth... the others are right. This isn't the end, just anothr hoop to jump through for whatever reason. Hang in thre. Your surgeons office wouldn't have come this far with you, if thy didn't think they could qualify you for it.
I know you must be sourly disappointed, but remember, everything has a reason, and maybe its just not yet time for the OK.. hang in there lady... appeal it all the way!!!!
I know you must be sourly disappointed, but remember, everything has a reason, and maybe its just not yet time for the OK.. hang in there lady... appeal it all the way!!!!
Patrece
JUST DO THE NEXT RIGHT THING!
Obesity Help Support Group Leader & Coach
http://www.obesityhelp.com/group/bariatricbuddy
Lost 114 lbs. working on getting rid of a recent 10 lb regain...and WILL succeed!
I sure understand how you are feeling. Many here do. But in the end.. you'll feel like.. "i'd do it all again". (even the frustrating parts) Thats how worth it this is. Never give up...never give in..
Patrece
JUST DO THE NEXT RIGHT THING!
Obesity Help Support Group Leader & Coach
http://www.obesityhelp.com/group/bariatricbuddy
Lost 114 lbs. working on getting rid of a recent 10 lb regain...and WILL succeed!
I can understand any frustration your having right now. Listen to the others advice and appeal. If you haven't done so already contact your insurance and see what the requirements are for having w.l.s. Before I even spoke to any health care provider I called my insurance and asked for information and I had a better idea of knowing if my insurance would cover me or not.
I was lucky in the aspect that my insurance approved this surgery after the first request was submitted. I did have to jump through some hoops when it came to my depression. Which set back my surgery date and made me more anxious and frustrated but everything has worked out well in the end. I'm certain if you work with your providers they can help you out. Don't fret girl.. keep trying! Good luck!
I was lucky in the aspect that my insurance approved this surgery after the first request was submitted. I did have to jump through some hoops when it came to my depression. Which set back my surgery date and made me more anxious and frustrated but everything has worked out well in the end. I'm certain if you work with your providers they can help you out. Don't fret girl.. keep trying! Good luck!
Teresa
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Patrece S.
Group Leader
Kathy B.
Co- Leader