Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Rant/Vent about Insurance



Recommended Posts

No appeal policy? Wow. What state are you in?

I'm in California, but it's not a State rule. It's an internal procedure with my insurance company. For this particular procedure, they are a one look, no right to appeal. That's why my surgeon's request for peer to peer has been denied twice. He keeps trying, going up the chain of command with each request. That's also why I have the request for Independent Medical Review pending with the Department of Insurance. The one look, no appeal is clearly stated in the disclaimer letter and has been confirmed by the stretta people who have faced that position from this insurer before.

Share this post


Link to post
Share on other sites

So if you have a DOI product, I'm guessing you have P P O coverage. As I understand it, no matter the product, in CA you definitely have the right to IMR.

Share this post


Link to post
Share on other sites

Yes, I have PPO. You have the right to request an IMR. The DOI has the right to evaluate whether the claim qualifies for an IMR. If so, they have 30 days from the date they receive a response from the insurance co to rule

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
    • RacMag  »  bhogue925

      Hi, I’m new here. I’m currently on the liver shrinking diet. So far so good, but I have to say I haven’t found a protein shake I like. Anyone have any suggestions please? My surgery date is September 17th. 
      · 2 replies
      1. BlondePatriotInCDA

        Fairlife Core are by far the best. They taste just as they are - chocolate milk. You can either get the 26 grams or the 42 grams (harder to find and more expensive). For straight protein look at Bulksuppliments.com ..they have really good whey proteins and offer auto ship plus they test for purity. No taste or smell...

      2. BlondePatriotInCDA

        Fairlife has strawberry, vanilla and of course chocolate. No more calories than other protein drinks. Stay away from Premiere, they're dealing with lawsuits due to not being honest about protein content.

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×