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Those who have dealt with a denial- what was the reason for the denial?



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I'm just curious what some of the reasons are.

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I asked my Dr. and he said reasons would be a low BMI. Another could be for not following the required visits (psych eval, nutritionist, weigh in's) and check in's have to be consecutively, no gaps. I am still in the pre-sleeved phase. Hoping for an approval in December. Are you waiting for an approval?

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Also not having specific information on your medically supervised visits. I had to coach my PCP because after I read his first note I knew it wouldn't be enough for the insurance company. They don't do this everyday so don't be afraid to coach him/her. I even wrote my letter of medical clearance and he was more than happy that I did it for him. He signed off on everything. My information was sent in to the insurance today so I'm praying for an approval.

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I was denied because I do not live by a center of excellence and I would like to have surgery locally. I am still appealing.

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I was denied becuz I wasn't on medication for my comorbidities.

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I was denied becuz I wasn't on medication for my comorbidities.

What?!?!? Are you appealing?

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Yes...appeal was accepted and I am scheduled 12/16/13.

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I was denied for not having the 2yr history they require I was under 40 with no comorbids ... I am now at a 41 with HPT and sleep apnea ... I just submitted my appeal papers OMG I am so nervous please send your positive vibes my way!!!!

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I was denied for not having the 2yr history they require I was under 40 with no comorbids ... I am now at a 41 with HPT and sleep apnea ... I just submitted my appeal papers OMG I am so nervous please send your positive vibes my way!!!!

Good luck with your approval! Hopefully you will hear soon.

That was one of my concerns. I was on the phone with the doctors office confirming if that could be a reason why I would be denied....uhg!!!

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I was denied because my letter from doctor was outdated. Got that fixed. They told me today that my doctor had to talk to someone at cigna. I have the bmi over 40 and 4 health issues. Dont see the problem. Very aggravated.....

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I was denied because of I don't have co morbidly issues. I'm scheduled for a sleep apnea test. I did everything that I was asked now this crap.

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Is your BMI 40 or over?

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Slipped band, bad patient b/c I haven't seen a bariatric doc in over 3 years. Won't convert, and will only take out slipped band if its emergent. I'm sad, mad and don't like the feeling I can't get the sleeve and I have a broken band. Crazy is - my current insurance didn't pay for this band, I was self pay on the other coast in 08.

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