Question:
My appeal was denied! How did you handle it?

I started this quest last December. I saw a nutritionist from Jan to May. I stopped seeing her when I was told I was approved and began all my pre-op testing. Just before my surgery date, May 25, I was told that I was actually not approved and must file an appeal. Today I was told my appeal was denied because I needed 6 months documented weight loss attempt. Had I continued with the nutritionist, I would have had 6 months by now! I'm so upset, I can hardly breathe. Have any of you had this experience? What did you do?    — Roberta M. (posted on June 15, 2004)

June 15, 2004
UPDATE:I called AWC (American Weightloss Center) and asked how long I was with thier program (from 2/6/03 to 11/4/03)all the documentation was sent to CIGNA, but they must not have added up the dates. I have asked the nurse to ask the doctor to write up something saying I was in his care last year. BTW, I start pursueing WLS in the beginning of December. My own PCP said I had to see a nutritionist for several months before he would refer me.
   — Roberta M.

June 15, 2004
Do you know if you were denied when they called the pre-cert # on the back of your ins. card? This happened to me all they were supposed to tell them was how many days I could stay in the hospital. Well I didnt know this to begin with so I had to do an appeal (surgery date change cus of that stupid person) and they denied again. Well I couldnt understand why one place said I was approved and the other said I wasnt, so I called and talked to a big wig at the Ins co. and she was not happy. She told me she would take care of it cus she was the one that had actually approved it in the first place. I got off the phone and 10-15 minutes later the other place called apolgizing and told me I was pre-certified for 3 nights in the hospital. All was well after that. I dont know what was said between the two, but I sure am glad. Good Luck!!!!! KEEP UP THE FIGHT!!!
   — Carrie W.