krenee

FINALLY, I am APPROVED. Surgery date has been set for May 29th

spoke with surgical coordinator today and she said they sent my case for the higher appeal. i am getting frustrated at this point. If they deny it at that level, then I might just give up. Are you preparing for your surgery??

I am sorry, I am asking so many questions.... But did you have to submit your weigh ins from weigt watchers or did your Dr. just write a letter documenting your weight loss efforts fro the last 6 months.

Did you loose any weight on the 6 month diet and was it a formal diet, or were you just working out and watching what you eat.

Great to hear. My peer to peer was denied. And now they are doing the external appeal. I hope I get the same results.......Please keep me informed of your progress. When did you complete your 6 month diet?

They did the same thing for me. My PCP wrote a letter and when they denied the inital claim, they said I did not have a medical necessity letter. So my PCP wrote a more detailed letter. Now I had to do blood work over and EKG. I hope I hear something positive as well. I called Lennox hill Friday morning but could not reach the surgical coordinator. which has also been very frustrating, because you always have to leave messages.. I dont want to seem like a bug-a-boo, but I am anxious!

If you don't mind me asking, what was the reason for the denial both times????

I have GHI/BCBS Camille, and they initailly denied my claim. my surgeon is in the process of doing the peer to peer appeal. So wish me luck.....I am so frustrated.

My inital claim to GHI/Emplem health was denied. My surgeon is going to the peer to peer appeal. Just sent in all the additional paperwork they requested. Has anyone had any success with the peer to peer???? I am getting really frustrated.

Well, I have been a little down. My inital claim was denied. Dr Yatco is doing the peer to peer appeal. Had to do blood work, EKG over. It is a pain the $%^&?, what the insurance companies make you go through...... I am hoping, that the peer to peer appeal goes in my favor. If it doesn't, I may just give up.....

@ Rosiegirl. My surgeon, Dr. Yatco is going to the peer to peer apepal with GHI. Did Dr. Roslin do the peer to peer appeal for you as well?

Well i encountered a minor setback. My insurance company GHI denied my claim. stating that I needed the 6 month diet. I was hoping I could get away with not having to do that. now that I have to resubmit paperwork, I am a little disappointed. Has this happened to anyone. The waiting is killing me...............

Has anyone been approved without having to do the 6mos diet requirement. If so, what did you include in your paperwork, in order to get it approved????

Well I was denied last week. I am sooo disappointed. I am calling my surgeons office tomorrow and requesting an appeal. They said I did not complete the 6month diet program

Did you do the 6 month diet, prior to submitting to insurance company.

I am from Mt. Vernon and hopefully will be having my surgery at Lennox Hill Hospital.

I am looking to get sleeved with Roslin's colleague Dr. Yatco. I was very pleased with my consultation. I have already had the psychological and seen the nutrionist. I am waiting for the letter from my PCP and I have an upper GI scheduled for this week, then off to the insurance company for approval. Hopefully Emblem Health/GHI will not give me a problem.

your information has been helpful because I have the same insurance through the city, and i wanted to know what the process was like with them.......

Has anyone had an issue with GHI insurance??

Has anyone had GHI insurance for approval?

Can anyone give me any feedback of their experience at Lenox Hill Hospital in NYC.

I just recently had my consult with the surgeon, Psychologist and nutritionist. Now I must have a series of test performed, in order to submit to insurance company. How long am I looking at before the surgery actually happens. I am very anxious to get it done.

I am going through my insurance. Has anyone had any problems with GHI