middlebeaver

Hi guys!! So I received the dreaded denial. My doctor and I sent in an appeal so now I wait, again. I know the time frame is 30 days, but what is your experience with appeal time frame before you are notified? Also, I would like to how many were approved or denied after an appeal. I look forward to hearing from each of you.

Speaking from experience, I wouldn't tell anyone other than close friends and family. Trust me, after a year or two passes and you gain 10 lbs or so back, which is pretty typical, a lot of people will talk behind your back talking about how you "failed" because you gained weight. The truth is no one is educated about wls unless you have it, but yet, everyone has an opinion about people who they have know what had it done and "gained everything back". I'm speaking of my co workers.

Well my surgery was revision, is yours? I had the sleeve in 2013. I have sleep apnea so I didn't have another sleep study. If this is your first wls I don't think you will have any problems at all! I received the denial 2 weeks after submitted. It's nearly been two months. I started this in January. I know you must be excited!!

Ins Finally approved!! Tuesday I called and I was told the appeal was denied, for the same exact reason the pre cert was denied in the first place. Apparently, who ever handles the appeal did not even take the time to read the appeal letter and documents. I called the appeals department and asked the names of the individuals involved in the denial and their credentials? She claimed the file was still "open" and they had one more day to make a decision, which was completely different than what my nurse said and a rep. After praying my little heart out; I received the call I was approved!!! What a journey! Fight, fight, fight!

Susie Q, i had the sleeve in 2013, and lost close to 70lbs. My doctor at the time sorta went MIA. Once I had the sleeve he was done. I paid for the sleeve with the hernia program. Not once did I talk to a dietitian, no pre opt what so ever. I sent my appeal in last week, now I'm just waiting for their decision. I was originally scheduled for surgery July 25th, I don't see that happening at this point.

I was denied as "not medically necessary". Basically, in a nut shell, they believe my last procedure failed because I didn't follow the program, which is not true.

How long have your appeals taken before you received word?

I asked my doctor about the peer to peer and they said in their experience it's a waste of time. I wish they would at least try. Sent from my iPhone using the BariatricPal App

I was denied because my psych evaluation was not ideal. I knew from the beginning of my visit with this shirk, this wasn't going to go well. She didn't say I should not have the surgery, but it is up to the doctor and patient. Secondly, I paid to have gastric sleeve in 2013, and they felt I didn't stick with it. I lost 70lbs, but that's where it stopped. I don't know what these people want. I'm filing an appeal ASAP. Obesity help.org has a form to use. Second, I have a new psychological scheduled for tomorrow. Sent from my iPhone using the BariatricPal App

I was denied today for revision. Sent from my iPhone using the BariatricPal App

Congrats!! Get plenty of rest! Sent from my iPhone using the BariatricPal App

Hi Elena, I know for my gastric sleeve I never did a liquid diet. The only requirement was to be NPO midnight before surgery. I didn't have any problems. However, I did not lose enough with the sleeve and have RNy schedule for 07/25 Sent from my iPhone using the BariatricPal App

Any revisions scheduled this month? Sent from my iPhone using the BariatricPal App

I'm tentatively schedule for revision on July 25! Sent from my iPhone using the BariatricPal App