Search the Community
Showing results for tags 'Peer to peer'.
Found 1 result
-
It has been one of those days to say the least. I called my insurance to check the status of my recently submitted papers for approval for bariatric surgery. To my dismay I was told I was denied because it wasn't medically neccessary. How can that be? My BMI is currently 66 and my weight is 422. I have sleep apnea and yes I sleep with a machine. I am borderline diabetic. I have high blood pressure. I have high cholesterol. I've got arthritis in my lower back, right hip, and my pelvis, making it very painful to do anything. I have Sciatic Nerve damage. I have Carpel Tunnel in both arms, and hands. I am ALWAYS out of breath. EVERYDAY I live in misery from the pain, and yet they say its not "Medically Neccessary". Are you kidding me? So now they are requesting a Peer to Peer with my bariatric surgeon, and yet the lady that handles the insurance stuff at the doctors office says she hasn't gotten a request. When they told me they sent one over, and their waiting on a response by tomorrow or else that's their final decision. I don't know what to do. I have come to far to give up now. I made sure I got clearance from my PCP, the Pulomonary Doctor, the Cardiologist, and the Gastroenterologist, and they ALL said it was "Medically Neccessary" for me to have the surgery. I also sent the last 10 years of medical papers showing that I have been battling with my weight forever. So now what? Does anyone know about Peer to Peer meetings and what are the chances of approval after having one?
