GOT MY APPROVAL

[trusso1003 2]

I have been trying to have this surgery for probably the last five years or better! And for reasons out of my control I kept getting pushed around and denied and would have to restart a program! I was about to give up until I gave birth to my little surprise and now I have heart problems and other health issues and well I need to be here for my girl to grow up! So when I got the news today that I was approved me and my girls just celebrated! ????????????????

[kliichow 42]

That is awesome. I had my own insurance issues. I've tried for the last 4 years to get my surgery and finally was able to get my approval in January. I already had all of my ducks in a row and was able to have mine a month ago. Good luck, I hope all goes well for you.

[denisestl 0]

I'm brand new here, very pre-op and stuck. Our insurance excludes bariatric surgery but human resource manager said he believes I have a good chance of obtaining approval. I really don't know what to do first. I am well acquainted with both health and insurance/legal issues professionally, but it seems that when asked to sort such issues out for myself no amount of training or experience makes any difference. I know I will need documentation from PCP and surgeon, will probably be required to do a pre-op weight loss plan, and a psych eval, but until and unless insurance gives the okay, I can't do all of this. On the other hand, until I do some of this I can't get the approval. Right? So where do I start? Congrats on getting your approval. You must be so relieved. It does not make me happy to be required to jump through such enormous hoops to obtain coverage for a highly effective treatment which is medical necessary to treat a legitimate disease.

Edited May 22, 2014 by denisestl

[Ginger Snaps 1,323]

@@denisestl First, if you need preapproval to visit a surgeon get that and go. I think the bariatric surgeons have magicians on their staff who can magically convince insurances to cover surgeries -- ok, maybe not magically but those guys are pros at working with insurance.

So, I would get to a surgeon and get his staff on board with helping you jump through all the hoops. They will know the best things to do to try to appeal to insurance.

Best wishes!

Edited May 23, 2014 by Ginger Snaps