Today I received my first denial for lap band surgery. While I was told by friends to expect a denial the first time, I am disappointed. I thought I did everything correct.
I am now going to appeal, but first just wondering what others experience has been with appeal and humana.
The denial states "available documentation does not indicate that this patient has a primary care physician who has followed her pre-operatively, agrees that she should have the procedure performed, and will follow her post-operatively after procedure is performed."
This to me sounds like maybe some information was not submitted to them. I did the 6 month supervised diet, and have the bariatric referral form from my primary care doctor.
Any comments? Thanks.
