I already had my sleeve surgery. I got a "preauthorization" from my insurance (Blue cross/blue shield of TX) for medical necessity (over BMI 40). I just got all the EOBs and every single one of them was denied. When I called the insurance they said that the "insurance" may have approved it, the "plan" didn't as they don't cover Bariatric surgery. He said I should appeal but because employer has that clause it's going to be a tough fight.
Any information you can provide on what to include (or exclude) in the appeal would be great.
I've not gotten a response from the doctors office (except surprise), so I think a peer to peer review is out.
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