Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

I was denied by my insurance company and plan on appealing the denial. Does anyone have a copy of the letter they submitted for the appeal? Any suggestions for the appeal? Any help would be greatly appreciated.

Share this post


Link to post
Share on other sites

Your appeal letter will depend on what insurance you have. Most insurance companies have appeals process that you have to follow. I would advise to find if your insurance covers the procedure if so ask what is the criteria is it may be that you are just lacking something small. If so then do what it still missing and have your doctor resubmit.

MC

Share this post


Link to post
Share on other sites

Your surgeon's insurance person will know exactly what your insurer requires. Will they handle it for you?

Share this post


Link to post
Share on other sites

I need diabetes, hypertension or heart disease in order to qualify. I have none of these. Do I have a leg to stand on? My BMI is in the 50's and I have depression and high cholesterol.

Share this post


Link to post
Share on other sites

What kind of insurance do you have?

Share this post


Link to post
Share on other sites

What kind of insurance do you have?

BC/BS through the plumbers union.

Share this post


Link to post
Share on other sites

Keep fighting because I don't have any illness and I got approved. If all else fails have a sleep study test, if your lucky maybe you have sleep apnea :)

Share this post


Link to post
Share on other sites

I just sent you a PM w/an excerpt from one of my appeal letters that you might find useful. Best of luck to you!

Share this post


Link to post
Share on other sites

If all else fails have a sleep study test, if your lucky maybe you have sleep apnea :)

So if I have moderate OSA I can qualify easier with my insurance? I have United Healthcare and they cover alot of stuff - I saw Dr. Grossbard & Dicicco (I think?) are in my network, but can't find bariatric services any suggestions?

Share this post


Link to post
Share on other sites

I also have United Healthcare and they covered the surgery with just mild sleep apnea. I have to say that my surgeon's staff also were excellent in working with them (so that may have had a lot to do with it). In any case, had my surgery last Tuesday, I feel great, have lost 12 lbs already. So please don't give up!!!

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • buildabetteranna

      I FINALLY HAVE MY DATE!!!!

      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Gearing up for my consult 01/14! Starting to get a little nervous.
      · 0 replies
      1. This update has no replies.
    • Goyafigs

      I had VSG 11.20.24 with Miguel Burch, MD Cedars-Sinai and I am 1 month post-op. 
      · 0 replies
      1. This update has no replies.
    • DaisyChainOz

      🥳 Jan 1 2025 - Day 1 of Pre Op, surgery on the 16th! 😬😅
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Just been waiting until time for my consult with my bariatric surgeon. It's scheduled for Jan 9th. Turns out I won't actually be seeing him. Apparently it'll be with his P.A.             Not sure what to expect. I thought this is where the surgeon would discuss the best surgery option for me. For years I had my heart set on the sleeve, but I've read so many people have issues with reflux - even if they've never had it before - that they've had to be revised to the bypass. I already deal with GERD & take 40 mg of Omeprazole daily, so I started studying about bypass and honestly, it seems like it might be the better choice for me. How can we discuss surgery options if the surgeon is not there?
      What happened at your first consult? Trying to get an idea of what to expect, or maybe I should say, what NOT to expect.
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×