Disappointed insurance denied

[DarleneCh 9]

I'm so sorry - that sucks. My insurance doesn't cover anything bariatric surgery related. It is so devastating. My dad loaned me the majority if the money to have it done. It is about half the price - they charge insurance about $23,000 but my cash payment was around $12,000. I am so nervous about going through with it - not only because so much of my stomach will be gone but I will be in major debt so that will add stress. Is paying cash something you could consider. I have payment plan set up for 6 years.

[BLERDgirl 6,417]

If your insurance covers it. I would exhaust all appeals.

[blondebomb 580]

Thanks everyone! I put a call in to my doctor's office. Waiting on a call back. I will be appealing their decision, I have come to far to just give up, lay down or sit on the couch. LOL.>_>>_>>_>>_>>_>

My next post will be Hip Hip Hooray, surgery on the 29th as planned. I have faith!!

will your surgeons office managers who fight for patients needing approval help?? between them doing their job working for you an you calling yourself to appeal hopfully it will happen!! have you had a sleep study for apnea? (you prbly have) just throwing it out there...hang in there!! my surgery was 5 months ago an I am still getting bills from drs I never heard of from that day..an a dietician who came in the room for 5 minutes an asked if I had questions an I said NO I have a dietician if I need one...thx..Im still calling my ins and having to rerun these bills thru for payment approval. been a pain..I told them listen I had my approval letter, so everything preop and postop NEEDS to be COVERED it all goes together! already had 2 bills go to collections an I hit the roof! told them if they sent another one to collections they would NOT be getting any more money out of me an to get them bills OFF my credit...I was upset..a lil!

[PaulaleeB 88]

My insurance dragged their feet for 6 months. Then I found out that the customer service rep from my health insurance co . Was giving my Dr.s office MISIN formation. !!!! So, before you give up, find out if the person fr your insurance co is giving accurate info regarding your policy. Just saying and good luck.

[ProudGrammy 8,322]

not a good candidate. I am pre-hypertension & 100 plus pounds over weight.

@@Mz. NuNu

when wlll all insurance companies realize that "THEY" (ins.company) would benefit just as much as we do by our losing weight

since our health issues will improve/be resolved - insurance company wouldn't have to pay for all those meds that "we" take (ie diabetes, high blood pressure et meds)

we would all feel and look great (many other benefits)

they would save a lot of money

win, win

so what is their problem

wishing you all the success you deserve

good luck

kathy

[peteyrulz 82]

So upset & hurt right now. For seven months, I have attended supervised weight loss classes, followed all guidelines from my nutrition & was looking forward to a healthier me. Only to be told that, since I have only had a BMI of 40 & above for 2 years with no co-mobs that I am not a good candidate. I am pre-hypertension & 100 plus pounds over weight.

I'm hearing that 2 year crap too. In my external review right now, after 3 denials. I hired Lindstrom Advocacy (not affiliated) & they are very helpful. No cost for phone consult.

[jjinWA 511]

I hate that there are so many of us out there that have been denied by our insurance company. Soooooo frustrating! Keep working with your insurance but keep in mind that there is another option. Both my daughters had run through the games and jumped the hoops only to get one denial after the other. Final choice was to have the sleeve surgery in Mexico. They are both 7 days post op now and doing great. Surgeon was FACS certified and surgery center was Center of Excellance. Both were credentials that my surgeon and surgery center had here in the US so I was confident they were in good hands. Thanks to this other option both my daughters are now on the losers bench with me. "Lovin it!"

[Proud2BMe 1,016]

@@jjinWA

Who was the surgeon and what was the hospital/clinic?

[jjinWA 511]

There are two surgery centers in Mexico with the Center of Excellence accreditation. My daughters went with OCC (obesity Control Center). Carolyn is the coordinator. I can hook you up with her contact info if you are interested. The surgeon is Dr. Ariel Ortiz. He is the surgeon that has FACS credentials. Surgery for me in the US was $28000 and for Dr. Ortiz in Mexico is was a fraction the cost. Carolyn can give you the specifics. I can tell you it is even cheaper if you schedule with another patient and share the hotel room. That saved my another daughters $1K!

I am pleased with the work Dr. Ortiz did and with his follow up protocols so far. Both the girls are progressing nicely.

The other surgeon we considered was Dr. Pompa. Her surgery center is also a Center of Excellence. She is a bit higher, but again I believe well qualified. I researched many before I made the decision to go with Dr. Ariel Ortiz. My daughters are very precious to me and going to Mexico was like going into the "unknown" so to speak.

Whatever the insurance co decides, don't forgo this life saving procedure simply because they deny you coverage. I would not accept someone else making the decision for my daughters and you don't have to either. For around $6K and a plane ticket you can soon be on the losers bench too!

Feel free to PM me if you would like to discuss further. Be sure to research Dr. Ariel Ortiz. There are two Dr. Ortiz practicing in Mexico. The other is not FACS certified.