approved then denied.

[txgirl 0]

:help: i have bc/bs of ill. after months and months of testing, labs etc. following there requirements to the T. they approved me on 11/17/06 or should i say pre certified. approve the hospital stay and not the biatric surgery. on 11/18/06 they said i had a exclusion in my policy. my question is when they are review your case and requesting all kinds of information. do they not also review you policy. i am doing the research now to appeal my case. at the time of the so called approval they called my doctors office and schedule my surgery on 12/04/06. and now i am left hang and depressed. after years and years of being over weight i finally, after alot of research and soul searching desided this is my only solution.

any one out there with any hope...:phanvan :help: :pray:

[Kat817 19]

Have you examined a copy of your policy to see if YOU see the exclusion? I would demand that at the very least. I don't know ifyou are keeping the surgery quiet or not, but you may get help from your HR person at work (or wherever the insurance originates). I would hold hope, since you passed all the other hurdles, this may simply be a delay type tactic, hoping to turn you away. Go through with the appeal! If you cannot see for yourself where the exclusion is, and if it was not in place when you began this, I would go so far as to hire an attorney.

Good Luck to you...come back and vent and keep us updated, we will provide as much support as we can!!! Welcome to LBT!

Kat

[dotofoz 0]

I would ask to SEE IN WRITING where it says that it is specifically excluded.