Very upset and scared I will not get approved!

[SouthJerseyMom 11]

I got a call today from my surgeons office coordinator... She is great and has been doing her best to get me approved by my insurance Anthum blue cross blue Sheild. I'm nervous because she said they need more information from my primary stating more health issues. I'm 5'4 225 and pre diabetic I've tried every weight loss program out there. And to top it off my husbands insurance changes June 1 so we are on a time crunch!!!! Ugh so upset?

Anyone been here before? If so please advise. I'm ready to give up!!!

[Spaness2012 609]

Try and just breath. It will all work itself out.

[carlak 59]

I was denied SIX times and was banded Monday.

[SouthJerseyMom 11]

Wow! That's unbelievable! Don't know how u did it!! I'm really thinking of financing it myself... How long did it take for you to get your insurance to approve? And what finally made them approve u?

[SouthJerseyMom 11]

Oh yeah and how r feeling?

[☠carolinagirl☠ 18,721]

I got a call today from my surgeons office coordinator... She is great and has been doing her best to get me approved by my insurance Anthum blue cross blue Sheild. I'm nervous because she said they need more information from my primary stating more health issues. I'm 5'4 225 and pre diabetic I've tried every weight loss program out there. And to top it off my husbands insurance changes June 1 so we are on a time crunch!!!! Ugh so upset��

Anyone been here before? If so please advise. I'm ready to give up!!!

ok, giving up doesnt solve a darn thing so knock it off missy

so what are you missing? did they give you a list/examples? if you have an inventory of what you need (medically from your past dr's) please go get it. i had too via my referral letter from my PCD for the insurance. and you still got 28 or 29 days til June 1......it will and can happen but stressing wont help..

so can you call whomever and see what you need today?

[SouthJerseyMom 11]

Thank u for your encouragement...my coordinator said I need to show more morbidly obese ailments and another letter from my primary doc stating her support and how banding will be good for me. My primary doc had already submitted a letter about my weight loss attempts and pre- diabetic state.

Bad thing is my BMW is not over 40...iI have no sleep apnea...no high blood pressure! I'm pre diabetic but she said that really doesn't count for approval. It seems because I'm relatively healthy I'm being denied! ?

[☠carolinagirl☠ 18,721]

Thank u for your encouragement...my coordinator said I need to show more morbidly obese ailments and another letter from my primary doc stating her support and how banding will be good for me. My primary doc had already submitted a letter about my weight loss attempts and pre- diabetic state.

Bad thing is my BMW is not over 40...iI have no sleep apnea...no high blood pressure! I'm pre diabetic but she said that really doesn't count for approval. It seems because I'm relatively healthy I'm being denied!

that is what i had to do...

what i did was write a (letter if you will) outlining all my adult life ups/downs

with weight and its listed in my records and then my PCD wrote the referral.

do you have the med records of all your (history)?

sounds like they want a (more detailed version)

same with me....so i wrote one myself..used dates/ weights etc...

what you think?

[carlak 59]

im doing well. Carolina girl coached me in the process, I followed her advise and I was approved!! Ive never been told that I wasn't fat enough for something. I was on the brink of self pay too, but I stod up for what I believed and the surgery cost me $25. I have my appeal letter saved on my work computer, when I return Monday and you want a copy of it Ill email it to you.

[SouthJerseyMom 11]

Hi carlack! So glad you are feelin good and returning g to work on Monday! If you could email me a copy of your letter I will be so grateful. My email is cathymly@ yahoo. Com! Thanks so much for sharing!

My primary doc will write me another letter in favor of the band and some additional stats. Hhopefully this along with my letter will get me the approval! All other test results and doc appointment info has been submitted?

[Mizz_Megan 40]

My drs office sent in my information and about a week later they required more information which was just proof of my weight for the last 2 yrs from my primary dr. I was approved 2 weeks later! Don't give up that's not how u get what u want! It will all work out u just have to jump through some hoops first. Good luck

[carlak 59]

Do you have a family history of heart disease or diabetes? Do you have knee or joint pain

[SouthJerseyMom 11]

My father passed away three years ago from congestive heart failure? he also battled diabetes and high blood pressure. His mother,my grandmother passed away very early in life from a heart attack... should i include this info in my letter?

My mother passed away from breast cancer at the age if 49. Do you think I should include this info? I did not realize family history will help my case. Please advise!

[PrettyThick1 1,860]

I got a call today from my surgeons office coordinator... She is great and has been doing her best to get me approved by my insurance Anthum blue cross blue Sheild. I'm nervous because she said they need more information from my primary stating more health issues. I'm 5'4 225 and pre diabetic I've tried every weight loss program out there. And to top it off my husbands insurance changes June 1 so we are on a time crunch!!!! Ugh so upset

Anyone been here before? If so please advise. I'm ready to give up!!!

Try not to worry, but it wouldn't hurt if your BMI was over 40 - you're just under 39. That's BCBS's "magic" number. Anything 40 and over is automatically approved, without co-morbids. I hate to say gain 10 lbs and try again...but...

[PrettyThick1 1,860]

My father passed away three years ago from congestive heart failure he also battled diabetes and high blood pressure. His mother,my grandmother passed away very early in life from a heart attack... should i include this info in my letter?

My mother passed away from breast cancer at the age if 49. Do you think I should include this info? I did not realize family history will help my case. Please advise!

The insurance review team will take all of that into consideration. If you are rejected, gain 10lbs and try again through a different surgical group in 6 months. Is there a True Results in your area? They do all the hard work for you, even after rejection they can get you approved.