So disappointed :'(

[Kiki1313 11]

So i found out today that my insurance denied my surgery. Im so depressed. Ive been crying almost all day. I just want my life back. This is so frustrating and i have no idea what to do.

[jacileggs 402]

Did they give a reason? Is there any way they will re-evaluate their decision either now or in the future.

[virgo66 9]

What does your practice say is the next step? My doctor told me if I were denied he'd do a peer to peer call and felt confident he could get it through. It means more wait time and hoops to jump through but if it gets you approved, it's worth it. Don't give up yet

[Ladiec2 74]

Hang in there. There's the appeal process. It may take you a little longer, but I'm claiming that it'll go through for you. What was the reason for your denial?

[Kiki1313 11]

Thank you ladies for being so positive. They said they would only repair the hernia i have. They said it wasnt necessary to take out the band and do revision to bypass. But that doesn't make sense to me since the band caused the hernia in the first place.

[Kiki1313 11]

My insurance advocate at my doctor's office is sending in the appeal this week. She said it should hopefully go thru and that it shouldn't take more than 2 weeks to find out an answer. I feel like I've been waiting forever already. And yesterday I just cried practically all day long. Im so depressed over this decision.

[Djmohr 6,965]

Hang in there. I feel so bad when I hear stories like this. Hopefully your doctors office will help push this through for you.

Don't let yourself get down, we all know what tends to happen when we are depressed.

I wish you all the best and will say a little prayer for you.

[Kiki1313 11]

Thank you hun. Im trying to stay positive but its hardim hoping everything turns out well with the appeal. Just i know that if i get my hopes up again just to be let down, its going to devistate me. Hopefully i can gain support thru this group of people. I know everyones responses have already helped in so many ways. Glad i joined this forum.

[campingkitty 3]

_{THERE IS HOPE!!! My surgery was denied too. The peer to peer was denied as well. I was supposed to have surgery in January. An appeal hearing was set for February 2 states away! I was beyond upset! Well, I guess after they received my letter and copies of my records they overturned the decision! I literally started crying at work when I got the call. My surgery is MONDAY!!!!}

_{Hang in there! Write a letter explaining all the problems you've had with the band.}

_{Best of luck to you!}

[Shanna213 7]

I was denied at first also. I think it standard practice to deny but just keep at it. My doctor had me approved within 3 mos. Even with the initial denial.

[Golflady 19]

If you could not tolerate it (everything got stuck) that is a good reason to have the band removed! Good luck on appeal!

[forabetterlife 3]

Any update on this ? Did your insurance approve it?

[Kiki1313 11]

@@forabetterlife i haven't heard anything just yet. It will be two weeks this Tuesday so im hoping i hear something soon. I've been calling and bothering my insurance company and i don't think that's helping. So I'm leaving it in God's hands and praying that they have enough information now to move forward with the pre authorization for surgery. Apparently it wasn't an appeal. It was a pre authorization process for surgery. Im guessing now if they don't have info they need then we do an appeal but im confused on the whole thing. The pain gets a little more sharp everyday and im hoping this nightmare is over soon.

[Kimberly Bouche-Perez 48]

I amj so sorry h that your are going through this. Sometimes, you need to, just sometimes, exagarate the poain a bit. I do NOT men flat out lie. what I am saying is you need to have in your doctor's history, how bad the bnd is hurting you. How you feel. So when the insurance company person who goes through hundreds of these a day, look at it and can say.

"well this person ha been back and forth the there pcp.many complaints and complications with the band. It will be cheaper for us to revise then for her to keep going back and forth to the doctor's plus meds".

This is how they think.

I had to jumo through many mnay hopes not for bypass but for my Tummy Tuck I got 4 weeks ago, today.

I was denied 3 times.

Then I got a hold of paper work with HOW to be approved.

Tjhye changed it from 12 months post op to 18 months... Done

3 viits to your pcp with skin issues. I had complained for over 1 year about the skin rashes but never had made an appt. just for that. So Done

Then I needed to hhave the plastic surgeon write a letter and pictures of the skin. AND my pcp had to write a letter.

Done Done and Done.

It took 7 weeks and I got approved.

Just don't give up!!!!

[LadyPullings 94]

Still no word? It'll happen exactly when it is supposed 2! Keep your head up! Stay positive!