rscaggs22 60 Posted October 8, 2014 Ugh. Another set back..letter from insurance today states my approval is "pending" because they do not have md notes, diagnostic testing, methods and dates of documented weight loss attempts. Per my surgeon, I was required to do the 6 month md monitored weight loss attempt. So I did the 6 months of classes, had the psych and dietitian clearances. What else do they need?? Or did my surgeons office not submit it all?? I'm calling tomorrow and hopefully they have received this letter as well and already fixed the issue. Share this post Link to post Share on other sites
rscaggs22 60 Posted October 8, 2014 Ok. So per Anthem they definitely do not have my clinicals. Called my surgeons office and the insurance gal is out until Monday and no one else can refax my documents. I asked and was told "we aren't going to go into her office rifling around in her paperwork...". Wow. Ok.... I'm very frustrated right now. This insurance gal has been full of excuses and explanations why things have been delayed. This Friday will be 3 weeks since my last surgeon consult and nothing has been received yet. First it was she wasn't sure which procedure I had decided on (even though it was in the dictation). Oh the sleeve? Ok, I will send it right over. (This was my first inquiry as to why my stuff hadn't been sent). Second time I was told that the Availity online submission program wasn't accepting my documentation for "some reason". So she had to fax the stuff and she said she did that last Friday. Got my pending letter from Anthem stating no supporting documentation. They have not received a fax. Called the office today, she's out, no one else can do it but the office manager said " she sent everything thru Availity". Uh no...ran thru the whole sequence of events and she didn't know what to say. So more waiting for me. I know ppl say the insurance companies are the hard part but my reps have been very helpful and encouraging. Sorry this post is so long- I just really needed to vent. Share this post Link to post Share on other sites
peteyrulz 82 Posted October 8, 2014 I'm having the same problem with BCBS/anthem. My appeal was sent in 9/8. Program coordinator said it took 30 days. Been calling every week. called the number on the denial letter.no one knows anything. Today, after being being on hold for 1 hr I was finally told she's not in. there's an hour of my life I'll never get back! ugh. so, I don't know anything more today than I did on 9/8. Thanks so much BCBS. Share this post Link to post Share on other sites
rscaggs22 60 Posted October 9, 2014 Why were you denied?? Share this post Link to post Share on other sites
rscaggs22 60 Posted October 9, 2014 I got my approval!!!! Don't know my surgery date for sure but the "tentative date" is 10/29. Share this post Link to post Share on other sites