Question:
Doctor said insurance company would probably deny me.

I went for my first visit today. What a HUGE dissapointment! He said my insurance company was at the bottom of the list and he was going to drop them soon. We spent most of the time talking about them. I have to have the pshy elev. before they send it in....I wonder if I should even bother....so depressed about it.....I think I will be fat forever.....    — P B. (posted on October 27, 2004)

October 26, 2004
THough doctors office do deal with insurances it doesnt mean they are always right... ALOT has to do with the patient! How hard you fight. They can submit and you can certainly appeal and fight your cause.
   — star .

October 27, 2004
Most doctor's offices any more are happy to submit your paperwork, but they expect you to fight for the approval if it comes to that. Your profile doesn't say what insurance company you have, but if it is notorious for non-payment, might be a time to change. Most companies this time of year are about to offer open enrollment and might be a good time to consider a change. I know I had to fight for mine. But there is hope--depends upon your fighting spirit.
   — Cathy S.

October 27, 2004
P B, DO NOT GIVE UP ON YOURSELF!!!! In this day YOU have to be willing to be your own advocate and FIGHT for what you believe in. If you want your doctor to fight then you need to show him that you want this and are willing to fight and wit for results. Get you pshyc eval and look into this open enrollment time and try to change insurances. Most insurance companies coverthe procedure if you meet the National Guidelines for morbid obesity with co morbidities. Look in the pamphlets for open enrollment. If you think you are going to change insurances then you may want to hold off till January (new insurances may want you to use their shrinks and MD's)Just a thought. Good Luck and God Bless. Sonja- San Diego(open RNY 9/9/04)
   — Son-Son

October 27, 2004
Call your insurance and talked to them. I made sure mine would pay before I even had a consult with my dr.
   — juju524

October 27, 2004
No way should you accept that as their final answer. There are always, ALWAYS, arrangements worked out. Every situation is different and you need to show them you are willing to fight. Good Luck Gary Viscio obesitylawyers.com
   — gary viscio

October 28, 2004
Call the phsyc. doctor, and tell them the situation. They should be able to squeeze you in BEFORE you get to the cut off date. Then call your insurance company and let them know when you are going. Once you get approved it doesn't matter when everything else falls into place....they HAVE to cover you if you are approved BEFORE the cut off date!!! Good luck, and God bless!
   — tedeebear

October 28, 2004
Don't give up and get depressed. Call and do the psych eval and whatever else is required. My insurance company was on the bottom of my doc's list, but I made sure I covered all my bases and had everything required. I was approved within a few days of submitting..... It all has to do with how bad you want this!!
   — Carmen S.

October 29, 2004
If you want this surgery you're going to have to do the leg work. Call your insurance and see what is required. Make sure your primary doctor does his part. I would also join a support group so you find out more about this surgery. I would also start watching what I'm eating. Some insurance companies require that you are starting to change your eating habits. If the insurance doesn't cover are you starting to think about self paying?
   — Linda R.

November 1, 2004
I just got approved after TWO YEARS of doing everything the insurance company required. I followed the insurance guidelines to the TEE. My doctor still accepts Aetna HMO, but they did tell me that it was hard to get approval. The doctor was right about that, but after two years of dotting every "I" and crossing every "T" I GOT APPROVED. Don't give up. Y
   — yvonne1953

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