Jessiegurl2686

Hey guys new to this forum!!!! So I've been dealing with this process since June 2012.... I'm 26 years old, 5'5 weigh 217. I've had a hell of a time getting all the correct info from my coordinator which finally quit or got fired. So I got denied last month because I never did my 6 month diet and did not enroll into the biriatric program.... So I was like allright should be easy to complete right! So I had my pcp sign a form with complete 6 month diet info. And then tried to enroll in program. So have them all my info and they said there nurses are 2 weeks behind but someone WILL call me. Waited for a month and called them come to find out the UN enrolled me because now I need TWO cormorbites..... I was never told any of this info since June . I have diabetes did my 6 month diet ... Sleep study and saw the phyco. So my next step is getting a attorney to appeal for me. Has anyone been though this before?!!

Well at this time I decided not to appeal with a attorney ..... I called my PCP and asked him to review my blood work and see if I was border line on any of my labs like blood pressure or cholesterol.... He said my cholesterol was borderline so I asked him of he could write a letter stating that and how it runs in the family..... So I called the bariatric program and tried to enroll again but they say it needs to be a medicated cormorbitity.... So I'm waiting for my dr letter to see if he stated its medicated ..... I've been calling everyday so see of he has written that letter and he hasn't.... It's been 2 weeks. Grrrrr I see my surgeon Monday was hoping to have it by then. But guess that was to much to ask. So I'm playing the waiting game like always! So I've been dealing with this for NINE months now. Hoping all the stress and waiting pays off soon.....

Took them 3 weeks to tell me I was DENIED! Well actually no one told me I had to call and find out..... Heart breaking

I'm hoping my insurance will approve me this go around. Just getting all my ducks lined up! Gonna submit again next week after my nut. Appt

Hey guys new to this forum!!!! So I've been dealing with this process since June 2012.... I'm 26 years old, 5'5 weigh 217. I've had a hell of a time getting all the correct info from my coordinator which finally quit or got fired. So I got denied last month because I never did my 6 month diet and did not enroll into the biriatric program.... So I was like allright should be easy to complete right! So I had my pcp sign a form with complete 6 month diet info. And then tried to enroll in program. So gave them all my info and they said there nurses are 2 weeks behind but someone WILL call me. Waited for a month and called them come to find out they UN enrolled me because now I need TWO cormorbites..... I was never told any of this info since June . And they could have called and told me i was UN enrolled. I have diabetes did my 6 month diet ... Sleep study and saw the phyco. So my next step is getting a attorney to appeal for me. Has anyone been though this before?!!

So I might have a another chance at this!! I called my pcp and let him know how I was denied for surgery do to only having 1 cormorbite and asked him to take a look at my labs to see if there was and level that I came borderline in ... Just called back and said my cholesterol was borderline and that he will write a litter staying its high and that I have a family history of this. I don't wanna get my hopes up but I have to say in alittle excited !!! so in the am I'm gonna call and try to enroll into the bariatric program again since I have 2 cormorbititys ! Please wish me luck as going to Mexico isn't going to go well with my mother!!!

Has anyone here used a attorneys office to appeal a denial from insurance company!??? If so why were you denied and also how did the appeal turn out for you?

I would have to pay 20%.... But the way it's looking this surgrey is out f the question for me... I'm <3 broken

Thank u! I will look into this more closely

According to UHC's website, you qualify: (updated 12/1/2013) Bariatric surgery, as a primary treatment for weight loss is proven for the following: 1. Class III obesity (BMI > 40 kg/m2) 2. Class II obesity (BMI 35-39.9 kg/m2) in the presence of one or more of the following co- morbidities:  Type 2 diabetes  Cardiovascular disease (e.g., stroke, myocardial infarction, stable or unstable angina pectoris, hypertension or coronary artery bypass)  Life-threatening cardiopulmonary problems (e.g., severe sleep apnea, Pickwickian syndrome, obesity-related cardiomyopathy) https://www.unitedhe...ric_Surgery.pdf

My surgeon referred me to the attorney.... That's what that office does.... Appeals against weight loss surgreys..... Kelly lindstrom out of California....

I already did a sleep study and it was negative . As of right now just medicated pre diabetes ..... They said I would need high blood pressure ...High cholesterol or sleep apnea

Thanks girls! In just getting frustrated with this whole thing. Got my hopes up for nothing . I had a friend go through this same weight and everything but I guess her insurance wasn't as strict . And she had no cormorbities ..... So should I call my surgeons office and ask them why I need an attorney and ask if they can appeal it???

It's 600 to have them appeal it. My surgeons office has been using them for years and have had pretty good outcome . I've done everything eles I'm supposed to do..... I'm just giving up.

United healthcare

I haven't appealed ..... My dr office said to go through a attorney they have used . My BMi is 35.9 ...and have one cormorbite. I have everything I need. I've been dealing with this since June and was denied last month because I didn't have 6 month diet and wasn't enrolled into biriatric program. I have all that taken care of now expect now they un registered me because I only have one cormorbite

What gets me I've had same insurance for 6 years.... Never had any surgreys .... Hardly went to dr. And the one time I need something for them they make it the hardest thing to get accomplished. There is always something . I think when I get my income tax I'm going to get an attorney to appeal it for me..... They have been doing this for 17 years and they said I would be a good candidate..... Ughhh just want this sooooo bad. I already told myself I was getting it. Now I'm like so upset they crushed my dream.