Denied..need More Information

[change4life2012 50]

I called Anthem BC today and was told I was denied. It was determined medically necessary but more information is needed. Has this happened to anyone else?? What else could they need? Anthem told me to contact my dr's office to find out what was needed. Its a holiday weekend and I wasn't able to reach my coordinator so it will be Tuesday before I can find out anything. Has this happened to anyone else??/

[peppersleeve 1]

Yes... And my doctors office sent updated paper work and i got approved.

[Patienlywtng on my Curves 73]

Yes, this happed with me as well. However, the insurance company told me why over the phone. I have since been approved.

[mysunflower621 69]

I was originally going for the lapband and started in March... got denied in May, June and July.. each time Cigna saying they didn't have something or I was missing information. Finally, my doctor's office got so fed up they FED-Ex'd everything to them so that they couldn't say information was missing... then I had to go up for appeal and had a date scheduled for August 10th. On August 9th I got a call to say that the appealate group (3rd party from Ins co) told the INsurance company they were "crazy" that no appeal was necessary, I met all requirements and was approved. NOW of course... me being me.. I changed my mind during that long wait and want the sleeve. So my doctor's office called Cigna to change the medical code (as this is normal practice and the requirements are all the same) and what does Cigna tell the doctor's office? That everything has to be resubmitted for approvals! ARE YOU KIDDING ME????? Every single piece of paper is the same!

I know what you are going through, hang in there and don't stop fighting for what is right. Make sure you stay on top of your physician's office and make sure that htey are submitting everything right and follow up with the ins. company too. The squeaky wheel ususally gets the oil!

I'm now about to go through it all again myself!