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

Recommended Posts

So I got denied for the vertical sleeve from BCBS of Tenn because it's investigation. If I want to resubmit my claim for lap band or the roux en y there would still be problems since in 2007 I had lost 10% of my body weight, etc etc... I am so piss... I Will be going to Mexico.

Share this post


Link to post
Share on other sites

I went through numerous denials, and finally won, if they are denying you based on Experimental/ investigational you can definitely beat that with no problems. I Have BCBS in NY and appealed the investigational / experimental denial and won easily, call your surgeon, and primary, all three of you need to write strongly worded letters to BCBS and submit them. You should call BCBS and ask to talk to a customer service supervisor, and explain that you want the appeal handled as a expedited appeal, this way the only have one week to answer your appeal. There are people on here that have copies of their appeals letters, and links to websites with appeals letters that have worked well.

Good luck and dont give up.

Share this post


Link to post
Share on other sites

Don't give up! Have your surgeon's office write a letter, your PCP write you, and you appeal immediately by phone, etc. Good luck!

So I got denied for the vertical sleeve from BCBS of Tenn because it's investigation. If I want to resubmit my claim for lap band or the roux en y there would still be problems since in 2007 I had lost 10% of my body weight, etc etc... I am so piss... I Will be going to Mexico.

Share this post


Link to post
Share on other sites

Mine was denied at first for the same reason and my surgeon talked to them directly and got it approved.

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

    • rinabobina

      I would like to know what questions you wish you had asked prior to your duodenal switch surgery?
      ยท 0 replies
      1. This update has no replies.
    • 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?
      ยท 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.

      ยท 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.ย 
      ยท 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.๐Ÿ˜’
      ยท 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

  • 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

    ร—