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

Got denied:(



Recommended Posts

Apparently my insurance company denied it, saying that the surgery wasn't covered. My the surgery center says it is and that they have a reference number or something from when they talked to them the first time! They said not to freak out and they have already filed an appeal. I guess it has something to do with codes and it being weight loss vs medical necessity? Idk, but very frustrating!! Especially since I've already been jumping through their hoops for 6 months now!

Share this post


Link to post
Share on other sites

What insurance company are you with?

Share this post


Link to post
Share on other sites

Hopefully it was just a simple mistake, and you'll have that approval very soon!! Hang in there!

Share this post


Link to post
Share on other sites

Regence blue cross blue shield

Share this post


Link to post
Share on other sites

Hang in there. The fact that the office is already filing the appeal seems to be a good sign.

Share this post


Link to post
Share on other sites

Thanks guys! And yes, I am so glad that my surgeons office seems so on top of things. My last appt was on the 9/12 and the appeal letter was dated 9/16. So that part makes me feel better. Unfortunately I feel like this is my last option, and this is what was gonna make it finally happen for me. So I am feeling fat, depressed and defeated

Share this post


Link to post
Share on other sites

Have you checked your policy? Give them a call yourself to be certain it is covered. Or look up your plan brochure online.

Share this post


Link to post
Share on other sites

Just wanted to give you guys an update. It was actually covered so they closed the appeal and opened a new case. They denied the new case because my 6 month pre op diet was 159 days instead of 180 days. Seriously!? So, today I'm going back for what really will be my last msd check in! Then hopefully it won't take much longer to get approved as it is an ongoing case! Hopefully...

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

    • 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!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • 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

    ×