NOT APPROVED

[vmurphy 0]

What are some of the reasons insurance companies give why they don't approve you?

I know the PCP has to write a letter, but Can I also write my own letter to send in with my forms for approval?

What are some tips and very important things to know that will help approve banding?

[trish151 33]

I don't think you have much to worry about. If you meet the BMI requirements or have other problems due to being overweight, you should qualify. I had more problems booking my apt with the surgeion than I did with the insurance company. I think a lot of people fall to the myth that insurance companies are against us but they really are not. Some people just try to break all of the rules. My paperwork was submitted on Thursday morning and Friday afternoon I called the insurance company and told them I was impatient and was just wondering if I could find out if it had been approved. The guy who answered the phone laughed and said he understood because he was impatient too. He told me that it had been approved but the letter to the Dr. office had not been generated but would be done on Monday. That helped my nerves over the weekenend but to be honest, I didn't have any expectations that it wouldn't be approved. If you meet the requirments and then do the insurance requirements, their is no reason you should be denied.

[Cocoabean 430]

Call your insurance company and ask what they require, IF they cover it. Some don't cover WLS at all.

They will let you know what their requirements are. Until you know that, there isn't much to be said. You may have a supervised diet requirement you might not. You might need 2 co-morbidities you might need 1. You might not need any, you don't state what your BMI is.

Do they require a referral from your PCP or can you self-refer? Do you need a 5 year proven weight history?

These are all questions we cannot answer, but they can. Give them a call. Or look online, most companies have their medical policy available to their members on the web.

Best wishes.