pjlajara 0 Posted June 7, 2007 Well today I got my first denial - I am very upset about it. I started this process in January, the paperwork was turned in on April 11. I called Friday (June 1) and it wasn't even in the system yet. I talked to the place where I am having it done and they said at least I now have a blueprint of what I need. One thing they require is a trial of a behavior modification program - anyone heard of that? Oh well, I will try to keep my chin up and see if I will have the surgury this year. Share this post Link to post Share on other sites
nursekathy2u 0 Posted June 8, 2007 What insurance do you have? Who told you it was denied?? I have never heard of a behavior modification program.. I have heard of a diet, exercise and behavior modification program.. Something sounds wierd here to me.. there must be some more specific reason you were denied. Share this post Link to post Share on other sites
pjlajara 0 Posted June 8, 2007 My insurance is great west - the letter from the insurance company i lacked the following: weight loss ; diet program for at least 6 mths within 2 yrs, monthly clinical from healthcare professional, trial of a behavior modification program, psychologial eval for this type of surgery, endocrine eval for obesity & post operative follow0up plan monthly for 6 months. I did have a psychologial eval for this so don't know what that is about. Share this post Link to post Share on other sites
omlagirl 0 Posted September 16, 2007 I too have great west and I am waiting to hear if they are going to accept my claim or not. What happened with yours? Share this post Link to post Share on other sites
pjlajara 0 Posted September 16, 2007 I am making monthly visits to the doctor so they can weight me. I have been 3 times so have 3 months to go. If you have great west, make sure that your request has been entered into the system. One of the problems I had was it sat there for like 3 months, I had to call for them to find it to enter the request into the system. Share this post Link to post Share on other sites
omlagirl 0 Posted September 17, 2007 Are you having your surgery locally or are you looking into going to Mexico? I think if I get denied by great west I'll be saying "Si" to Mexico. Share this post Link to post Share on other sites