Question:
HOW CAN I GET MY SURGURY APPROVED?

I'M CURRENTLY IN AN APPEAL PROCESS WITH MY INSURANCE COMPANY - THE SUGURY IS MED. NECASSARY - I HAVE SLEEP APNEA(WEAR A CPAP) - MY BMI IS 62 - W/ A FAMILY HISTORY OF MEDICAL PROBLEMS THAT WILL WORSEN W/O SUGURY. NOTHING ELSE HAS WORKED. HELP    — SHERMIE101 (posted on October 16, 2007)

October 16, 2007
You might want to check into the South of the Border/Mexico site. I went to Mexico to Dr. Aguirre and have had wonderful result with no complications. Neisha
   — neisha =.

October 16, 2007
Keep appealing until you cant appeal anymore. I had to appeal and was denied 2 times. the 3rd time it was approved and i hurried as fast as i could to surgery. it gets tiring to keep sending all that paperwork in. see more dr's, get more tests. but it is worth it all in the end. Dont give up.
   — shalmar

October 16, 2007
What kind of insurance do you have?? I agree with the other person keep appealing. I had to appeal twice. I got it approved on an external appeal. If you need any help let me know. I would be more the will to help you. I have a background in insurance
   — Kjackson2

October 16, 2007
I agree with Shalmar - insurance companies count on the fact that people will accept first rejections - believe me, I know this is true. I haven't yet had to go through the insurance approval process, but I've been disabled for 3 years and have sometimes had to appeal 3 & 4 times to get what I needed. Someone on one of the OH forums had a great letter she was willing to share to get approved - maybe if you posted in the general forum as well as the forum for whatever surgery you're having she'll see it and repost the letter that allowed her to be approved. Good luck!
   — obeseforever

October 18, 2007
Make sure your PCP is on your side and have him/her go to bat for you. They will refer you to the surgeon for you who accepts your insurance and make sure the surgeon will push for you to have surgery and will file accordingly with the insurance company. Some docs have a way of getting the job done.
   — KRWaters

October 18, 2007
Keep your head up, and fight! My insurance co. treated me terrible through the whole process, and then denied me the first time. I cried for a few hours and then got mad! I put together an appeal letter that couldn't be denied (go online to find out to write MEDICAL appeal letters) and get everyone, I mean anyone and every medical person you know to write a letter of recommendation for you (even bypass/lapband surgeon) Let us know how it goes. Shelley Wears- MO.
   — shelley09

October 19, 2007
i am in the same boat except. if i dont have surgery i will get bigger w/ more health issue that will require more money!, i dont have cpap, and i dont think i have sleep apnea.. i was supossed to go get tested but i dont wanna deal with that shit. lol. but um just keep appealing.. i know acchss is covered 100% good luck.. i am still waiting. its goimg pretty fast even though i dont have surgery date yet.
   — Kimberly F.