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A big disappointment.



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I finally got the phone call i have been waiting for from the financial reviewer yesterday about the insurance companies decision. I GOT DENIED....WTH.... Seriously how is that even possible. Come to find out my last health care provider didn't schedule me for a full 6 months weight management it was 5 1/2 months.... really. And they said i gained 4.5 ponds then. Plus now my insurance company ( Priority Partners) started a month ago where your required to keep a food log and exercise log.... i was never told this when i was doing all the requirements. So i balled like a baby because this means i will have to start the process and tests all over again. What the insurance company fails to give a crap about is that i have a large ventral hernia that has been causing me pain and health problems since i had a c-section with.my lil girl 2 1/2 years ago. Yet now i will have to wait another 6-8 months for WLS and then another 6-8 months after that for the hernia surgery. Im Soooo frustrated i just want to crawl in a hole and give up. This isn't fair that i have to stay in pain and suffer longer because my old doctor don't know how to freaking Count.

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Do what my mother and I did. We call our insurance to see why we got denied

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Most insurance companies have an appeals process. I would call.

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I can relate to your frustration and pain. I have been battling with my insurance company for a while now. I originally started for a bypass in 2010. Did all of the requirements to meet for the surgery and was denied the first time due to being underweight. Even though, I was applying for the surgery not for weight loss totally, but for other health issues. I did call my Dr.’s office back at the time and had them do an appeal which was eventually approved. However, since the approval the military has changed insurance companies from Tricare to United Health care and I am starting all over again. I am hoping that it will go a bit fast since my health has taken a very nasty turn. Try for an appeal process if the office does them first before you try another 6 months program. However, in the meantime make a point to record your meals, exercise , or any other requirements they need. Find out if they need other diagnostics as well such as a sleep study, EGD, etc…. Don’t give up, this is a bump in the road and you can get past this just stay determined. Best of luck! :D

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I wouldn't have to do the EKG or sleep study and blood work again. My new doc just did EKG n redid my labs and the sleep study I did back in feb of this year and was diagnosed with Severe Sleep Apnea. I did call the insurance company to find out about the appeal process and gave my doctor all the information because he is the one that is required to appeal in writting. Anyway the insurance requires logs but don't have a clue how to obtain them to fill them out. I think that's just another stupid loop hole for another denial. But I'm really frustrated.

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So does anyone know of how to do a blog and post their journey on like fb or something like that

You can do a video blog and chronicle it on youtube. That's what I'm doing. I don't know much about computers but do know how to work my camera phone lol. Best of luck to you.

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Appeal. Have your doctor involved in the appeal. He can write a letter on your behalf. If you can get more than one doctor to do it, even better.

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