am i just setting my self up for dissapointment?

[amyskieblu09 0]

Hi my name is Amy I am getting ready to see Dr.Schumacher in miamisburg ohio who works with kettering baratrics on April 12th. My insurance is molina health care ( of Ohio), my weight is 275 with a bmi of 44.3 how can i get molina to approve having the vertical sleeve gastrectomy, I have asthma, prediabetes (which i am on metformin 2x a day). arthritis, borderline high cholesteral and high lipids along with anxiety and acid reflux . what are my chances of getting approved or am i just setting myself up for a denial?

[Tiffykins 673]

Unfortunately, I'm not familiar with your insurance company. But, do not give up, and don't settle for the band especially with your co-morbidities. You can appeal if you get denied, and it will take time, but it's so worth it.

Keep us posted on what you hear from your surgeon's office. If you need help with appeal processes and letters, I have some saved for others use.

Best wishes, and fingers crossed for approval ! ! !

[sleevegenie 0]

Hey Tiff, well i'm sick with all this, i got a letter saying not a denial of service, contact Anthem blue cross utilization dept for decision about investigational called that dept 3 times told they dont deal with HMO go back to the HMO , hmo says appeal, so i appeal and on the 30 th day of appeal get told you havent'been denied so cannot appeal yet, what?? now i've been denied and have to appeal again, so i'm thinking of editing my appeal letter, can you send me the letters you mention in this message, i'd really appreciate it, trying not to let it get me down thanks