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

Recommended Posts

I am now just waiting for approval form the insurance. I have done all that they ask and require but I am still worried that I will be denied coverage. Has anyone ever been denied even though it is a covered procedure?

Share this post


Link to post
Share on other sites

Denials aren't typical assuming a few things:

* You don't have an employer-enforced exclusion. Did you check on this? Just because [insurance company] doesn't exclude something, does not mean it is covered in your plan.

* You meet the plan's medical requirements for the surgery.

* You don't mee tthe plan's qualifications for denial (a concern more in future years than right now).

WIth those conditions met, you should (not will, but should) be approved. If you are not, you need to find out the specific reason for your denial and appeal it.

Insurance companies follow guidelines. They cannot arbitrarily deny procedures. Their rationale may not make sense to you, but there does have to be some rationale there.

(Used to work for an insurance company)

Share this post


Link to post
Share on other sites

Definitely check your insurance plan's requirement for coverage of the procedure. I went through this just last week. I was sooo nervous even though I met the requirements (according the benefit hankbook). I was paranoid that the authorization wouldn't come though.

The suspense got the better of me in the and I called my provider directly and asked if it had been approved. I couldn't wait to get the call back from the surgeon. They told me that it had been authorized. Woohoo!

Just call your provider and ask directly

Share this post


Link to post
Share on other sites

They shouldn't stress us out like this- for real.

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

    • rinabobina

      I would like to know what questions you wish you had asked prior to your duodenal switch surgery?
      · 0 replies
      1. This update has no replies.
    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

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

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

  • 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

    ×