Insurance Doesn't Cover, Submit Letter?

[Wisdom2KnowTheDifference 32]

So I found out today that my insurance does not cover WLS, but I was told my doctor could submit a preauthorization letter which would be reviewed. Has anyone had any experience with this? Specifically trying to get Lap Band covered by an insurance company that is expressly saying they don't cover it?

[highland 168]

No luck here. My employer specifically excluded WLS so no matter whT my surgeon wrote, they denied me. It's upsetting because my i surance company has benefitted greatly from me losing 100+ pounds! I was tKi g massive amounts of insulin that was costing them $5000 per month. I know take 1/10 of that amount!!! By self paying for lapband they also will not cover anything related to it like a tt or panilectomy. I just had had a tt and br which I also paid for! With that said, I wish you all the luck in getting approved.

[kloee 1]

I to was denied the first time, so i wrote a letter to appeal it also had a letter that my Dr. wrote up. Explaining that i had dieted and tried many diets in the past. Sent it in and got approved. I was not at the B.M.I. index that was necessary for the surgery but net the sleep apnea and high cholesterol and blood pressure.

[kloee 1]

I also have the letters that i wrote to my ins. company if you would like them. I received them from a lady i met on this forum that was also denied. One is a personal plea, the other is explaining my medical side of it.

[xavtay2 85]

Good luck on getting your approval. I just sent a certified packet today with my office letter of appeal to Cigna. I wish I would have had your letters. If you can please send them to my personal email: xavtay2@gmail.com. They still may come in handy, I was denied because of the facility my insurance does cover WLS. we will see the outcome as I am sending positive energy to everyone affected in this way. I believe that it will be apprived I just have to fight for it. Good luck and keep in touch

[NWgirl 574]

Good luck on getting your approval. I just sent a certified packet today with my office letter of appeal to Cigna. I wish I would have had your letters. If you can please send them to my personal email: xavtay2@gmail.com. They still may come in handy, I was denied because of the facility my insurance does cover WLS. we will see the outcome as I am sending positive energy to everyone affected in this way. I believe that it will be apprived I just have to fight for it. Good luck and keep in touch

Some insurances require you to get surgery at a center of excellence. If this is what you mean by facility, I don't think they will approve a place that is not a center of excellence. Center of Excellence locations have extremely strict requirements which are set forth to ensure the best patient care and outcomes.

[xavtay2 85]

Hey NW GIRL~

Thanks for your response and you are correct. The only problem is I was told by two different insurance precertification representatives that the listing of Center of Excellence hospitals they are using is outdated! To be exact one rep said October of 2011 and last week another lady told me it was dated back 2009. I jsut think they need to use a current listing prior to giving me a denial..

[NWgirl 574]

Ooh, that is a problem!!! So the one you want to go to is a center of excellence but their records don't reflect?

[Bubie1916 59]

I also have the letters that i wrote to my ins. company if you would like them. I received them from a lady i met on this forum that was also denied. One is a personal plea, the other is explaining my medical side of it.

. How can I get a copy of your letter or sample to help write my insurance? I just got denied and want to appeal it. Can you help me?

[A_in_Jade 0]

I also have the letters that i wrote to my ins. company if you would like them. I received them from a lady i met on this forum that was also denied. One is a personal plea' date=' the other is explaining my medical side of it.[/quote']

Id love them too! Can u send to my email? Message me!

[Bubie1916 59]

I also have the letters that i wrote to my ins. company if you would like them. I received them from a lady i met on this forum that was also denied. One is a personal plea, the other is explaining my medical side of it.

. Kloee, my emai address is: emat704@Verizon.net- I would really love to get copies of your letters, as I will be appealing. Thanks!!

[kloee 1]

sent you a e mail

[Bubie1916 59]

sent you a e mail

. Thank you so much!! Happy 4th!!!

[chevy_truckin 0]

Hi I am trying to get mine done I am looking for a good doctor real soon in ky and was wondering I you could send me a copy of those letters to be ready if they deny me since my work has it excluded

[chevy_truckin 0]

Sorry my email is cardude32246@yahoo.com