ShineBright724 70 Posted August 4, 2013 Just got my letter from my insurance and I was denied! What do I do next? I'm crushed. Share this post Link to post Share on other sites
Crkrjax76 76 Posted August 4, 2013 Find out why you were denied. It could be something as simple as something didn't get turned into the insurance. Then you might have to file an appeal. I wish you luck!!!!!!!!!!!!1 Share this post Link to post Share on other sites
liane 30 Posted August 4, 2013 Oh no! I am waiting for approval as we speak. My surgery date is the 15th. When i spoke to my insurance company Friday they said if I was denied a reason why would be included. I am just hoping and praying it is not denied. I will hope for you that it is something simple and you will be approved in the near future!! Share this post Link to post Share on other sites
Sparklette 381 Posted August 4, 2013 Call them and ask why, I could just be a paper work issue. Appeal, have your surgeon and pcp give your insurance a letter of medical necessity. You journey isn't over because you hit this bump. Share this post Link to post Share on other sites
ShineBright724 70 Posted August 4, 2013 The letter said I failed to prove that I failed non surgical weight loss methods. What have I been doing for 7 months?! I listed all the failed diets I've done... Share this post Link to post Share on other sites
life_after_gastric_bypass 214 Posted August 4, 2013 I would call back and find out if maybe you missed something or did they forget to send something...keeping u in prayers and fingers crossed Share this post Link to post Share on other sites
SoccerMomma73 1,867 Posted August 4, 2013 Don't freak!!! (Easy to say, I know). There are so many things that can go wrong with the paperwork trail, talk to your program director tomorrow and call the insurance company too. It could be as easy as someone clicking A instead of B when entering your data. Good luck!!! Fingers crossed for you!!!! HW 312, pre-op (RNY) 255, current weight 202.6 Share this post Link to post Share on other sites
JustRick 8 Posted August 4, 2013 I too was denied a few weeks ago. I contacted my surgeon's office and asked them to help with the appeal. The had a peer to peer phone call and the insurance company reversed their decision and approved me in two weeks. Turned out to be the doctors office failed to include all the pertinent documents. All is good now August 21 is my surgery date.... Good Luck Rick. Share this post Link to post Share on other sites
MrsS 2 Posted August 5, 2013 Just got my letter from my insurance and I was denied! What do I do next? I'm crushed. I'm so sorry to hear that but everyone is right there might have been something missing! I was denied twice before getting an approval. They kept saying I had not provided adequate proof that I tried to lose the weight and then they said my BMI wasn't sufficient even though I had the lap band and it failed and my BMI was well within the numbers. After my surgeon called the head of insurance they told me that if I hit a certain level they would approve me no questions so I had to do three more months of weight loss documentation. Sometimes they play these games just to prolong it. See if your insurance has a time limit to resubmit because sometimes that is a shorter time than appealing it. Good luck!! Share this post Link to post Share on other sites
Band Mom 3 17 Posted August 5, 2013 Just got my letter from my insurance and I was denied! What do I do next? I'm crushed. Oh no! All of the previous posters are right-you should get on the phone tomorrow and have your dr.'s office start working on it right away. I am anxiously waiting to hear back from my insurance company...I will pray that your issue is resolved quickly and comes back approved! Share this post Link to post Share on other sites
liane 30 Posted August 5, 2013 For those that were denied...did anyone have BCBS? I am waiting for approval and wondering if I should be worried... Good luck with the phone calls!! Take care Share this post Link to post Share on other sites
ShineBright724 70 Posted August 5, 2013 Thank you everyone! I'm going to call my surgeons office tomorrow and see what the next steps are. I have BCBS/Blue Care Network.. Share this post Link to post Share on other sites
Band Mom 3 17 Posted August 5, 2013 For those that were denied...did anyone have BCBS? I am waiting for approval and wondering if I should be worried... Good luck with the phone calls!! Take care Ugh! I have BCBS too. Share this post Link to post Share on other sites
ShineBright724 70 Posted August 5, 2013 Well I was told that BCBS isn't too picky. I'm hoping it was lack of paperwork or something for me. Good luck!! 1 Band Mom 3 reacted to this Share this post Link to post Share on other sites
MrsS 2 Posted August 5, 2013 For those that were denied...did anyone have BCBS? I am waiting for approval and wondering if I should be worried... Good luck with the phone calls!! Take care I have BC/BS but after the first denial they gave me approval. I feel like they do that just to make sure you really want it. Share this post Link to post Share on other sites