denied by nj horizon bcbs for band, now what?

[m_kuiphoff 1]

HORIZON DENIED MY AUTHORIZATION FOR BAND SURGERY. WHAT DO I DO NOW? SHOULD I CALL MY SURGICAL COORDINATOR?

[catlover602 85]

My health insurance does not cover any wls. I had to finance it through care credit. I went through true results. I had to do something. My weight was getting out of control. If you can, look into financing it yourself. I sold my truck bought a older Nissan and the rest is history. I'm worth it! And don't listen to your family who says you can do it on your own....Best wishes.

[m_kuiphoff 1]

Thanks I know my insurance covers it. I dont know whether I appeal it or the surgical coordinator at my drs office.

[mmrennau 58]

I have heard many times bcbs almost always denied it first time as they want extra weight loss documentation so I suggest you talk with your wls people and they will guide you on what to do next. The woman who is responsible for insurence stuff for wls at my office told me they usually accept it after u appeal once. It's a slightly longer road but it will happen. Keep going!!

[kvlasy 195]

Definitely call the coordinator.

[m_kuiphoff 1]

Thanks I'll call them Monday.

[m_kuiphoff 1]

Surgical coordinator said don't panic. They're going to appeal. Does anybody know how long that takes?

[blbaltazar 6]

How much was it of you don't mind me asking? Cat lover

Edited March 5, 2015 by blbaltazar

[mmrennau 58]

Surgical coordinator said don't panic. They're going to appeal. Does anybody know how long that takes?

From what I was told it can be anywhere from a week to 30 days. It really depends on your insurence. I have seen people on here say they call their insurence after 7 days and ask them if they have an update on the appeal and they will tell you.

[m_kuiphoff 1]

Started this process in Dec. Still waiting for insurance approval. What to do?

[mmrennau 58]

u probably have another month left to wait your cordnator can tell you how long insurence process typically takes for an appeal with your insurence. also they will tell you why your insurence denied you to begin with. call your cordnator that's what they are there for to help you through the appeal process and answer any questions you have.

[m_kuiphoff 1]

Thanks. I dont know if there,s an appeal max?

[m_kuiphoff 1]

My appeal is pending. What does that mean? Are we getting closer to a surgery date?