Has anyone had to dispute insurance denial?

[tfarr 270]

I've had topics on here before about what I'm going through,but, it's possible after I go through everything I may not qualify for the surgery due to non qualifying weights. ( I've been 2 lbs off each weigh In except today's)

I do not have co-morbidities. The PA said if I go through everything there is a chance my ins may not approve due to the weights.

I just want to know if anyone has has to fight with the ins company to get approved?

Thank you so much

Tracy

[brinana30 16]

I am going through that very thing right now. Insurance denied me because I had shown a weight gain during my weight management, but at my last weight management appt i had shown a weight loss of 20lbs. Insurance claims they did not receive my paperwork from May which is the month that shows the weight loss. My doctor is going to do a peer to peer phone call with my insurance to have the decision reversed. My doctor also told me that they were not giving the requirement that I could not gain weight. So, I am hoping to receive good news soon.

IF your insurance denies your request then you should have the option to appeal their decision. I would talk with your surgeon to find out how to go about something like that. For now, stay positive! You never know, you could be approved! ????

[tfarr 270]

Wow, insurance companies are something huh? I hope your doctor is able to have them reverse their decision.

We go through all these appointments, nutrition counseling, psych eval, pre-op meetings, exercise physiologist and 6 hr pre-op groups ( where I go that's what they require because they are accredited) just to hear "No"? Doesn't seem fair.

Thank you for sharing your experience, it's helpful to know someone else is dealing with something I fear and is able to set my mind at ease.

Thank you again

[Skywalker 170]

I've had topics on here before about what I'm going through,but, it's possible after I go through everything I may not qualify for the surgery due to non qualifying weights. ( I've been 2 lbs off each weigh In except today's)

I do not have co-morbidities. The PA said if I go through everything there is a chance my ins may not approve due to the weights.

I just want to know if anyone has has to fight with the ins company to get approved?

Thank you so much

Tracy

I just want to make sure I'm understanding this correctly....did they disapprove you because you were two pounds too thin and had no co-morbidities?

[tfarr 270]

I'm the best at leaving Info out (sorry)

Im still going through the process. The PA tasked me a couple visits ago if I wanted to Pursue this anymore because my weight is only a few lbs shy of the required weight and that into ins may inot approve

Because of being 3 lbs off at all of my weigh-ins and not having co morbidities.

So I was just wondering if it's worth going through all with the possibility of being denied.

I'm going too now, before I wasn't sure,but I now