Denied, Appeal And Or Take It To Court.

[Alaskanband 5]

Was denied from premera blue cross blue shield. They said i didnt have enough documentation from my dr. They lady at the surgrons office told me that the surfein was going to talk with the insuranxe company this thursday. She then told me if that doesnt work that the company that makes the band will take it to court for me free of charge. She aaid they saways win. I'm not sure what to think about that. Has anyone else heard of this?

[DELETE THIS ACCOUNT! 12,703]

I've never heard of a band maker taking an insurance company to court, however if they said the reason for denial is a lack of documentation from your doctor, why not find out what documentation they're missing and give it to them? It's not like they're denying saying they don't cover weight loss surgery, they're just saying they're missing some of the necessary paperwork. I would think that should be a pretty easy fix.

[kll724 3,055]

Good luck, I have never heard of that either. My son-in-law has been denied and the insurance company would not even speak to the surgeon. Best wishes for you, tho'. Karen

[Justme9786 50]

I appealed w/my insurance company for 8 or 9 months before they finally approved.

[aprilshowers1725 2]

When I was getting approved they said my doctor didn't fill something out right. All I had to do was resubmit it with it fill out correctly.

[Alaskanband 5]

They told me my Dr. Didn't write down enough documentation. They said he should of taljed about calorie intake and talk about a specific diet. I remember discussing those things with him. I guess thry never made it onto paper... I'm hoping the meeting on Thursday will correct it.

[DELETE THIS ACCOUNT! 12,703]

They told me my Dr. Didn't write down enough documentation. They said he should of taljed about calorie intake and talk about a specific diet. I remember discussing those things with him. I guess thry never made it onto paper... I'm hoping the meeting on Thursday will correct it.

It sounds like the problem is your surgeon's office. I also wonder if maybe they don't require a 6 month doctor supervised diet before covering it, because of their mention of a specific diet. Many insurance companies do that, too.

I do know this, trying to go after your insurance company legally would be a waste of time. Because they will cover it with the right documentation, there isn't a case against them.

Good luck, I hope they straighten it all out for you on Thursday.

[Alaskanband 5]

Yeah i'm still not sure what to think about that. The court thing was brought up by the surgeons office.

[Alaskanband 5]

So the insurance rep missed his call last Thursday. It was reschudled for this Tuesday. Hopefully things work out!

[MrsJroChicago 32]

Stay on top of it. Get the specific list faxed to you and sit down with the doctor and his office to go over it and it done right. You have to be your own advocate.

[Alaskanband 5]

I was approved. Now i have to figure out all the details. And make up my mind!