Denied --

[hazelzay 75]

My doctor called me and told me my insurance denied me because they didn't receive all of the paperwork for my 6 month weigh in and nutritional visit when in fact they did and never even called my doctors office to resubmit the paperwork. I called my ( third party pre approval company ) from BCBS that's reviews it and they said that was really the only reason and that I do have a BMI of 40 with obstructive sleep apnea and that I have to resubmit the packet again . I just don't want them to deny me all over again . Has anyone else been through this ?

[Christinamo7 4,042]

hopefully it will not have any issues this time. if it does maybe they will give you a copy and you can make sure they have everything yourself. keep us posted!

[hazelzay 75]

hopefully it will not have any issues this time. if it does maybe they will give you a copy and you can make sure they have everything yourself. keep us posted!

Hopefully . Thank you ❤️❤️

[Clarevoyant 347]

Ugh sorry that is so annoying. Did they resubmit today? Maybe you can call insurance tomorrow and ask them to confirm they got everything?

Sent from my iPhone using the BariatricPal App

[Auntie74 4]

I had the same situation happen this week. Cigna said they didn't get the physician recommendation form. The surgeon's office resubmitted yesterday and said it could take up to 30 days. I was devastated by the news. I'm trying to keep the faith.

[hazelzay 75]

I had the same situation happen this week. Cigna said they didn't get the physician recommendation form. The surgeon's office resubmitted yesterday and said it could take up to 30 days. I was devastated by the news. I'm trying to keep the faith.

Me too I'm crossing my fingers for both of us . Part of me thinks the insurance company just says this shit because I was reading their people said this to them . My stepmom works for an insurance company and she said sometimes people in the doctors office aren't responding to certain things the insurance company request .

[Diana_in_Philly 1,426]

Keep a detailed log of your phone calls, including the date, time and name of the person you speak with at the insurance co or their TPAdministrator. Keep copies of everything you send. Ask who specifically the information must be sent to, either by email or fax, and then keep the "receipt" from the email or the fax. Call 2 hours after sending to confirm receipt. Get the names and titles of each person you speak to. Make it clear to them that you will hold them accountable.

If you are in a plan provided by your employer (and your employer has more than 50 employees and is not a local or state entity) feel free to say something like "I really don't want to have to get an ERISA attorney involved."

[hazelzay 75]

Ugh sorry that is so annoying. Did they resubmit today? Maybe you can call insurance tomorrow and ask them to confirm they got everything?

Sent from my iPhone using the BariatricPal App

She was suppose to fax it again . I'm going to call them tomorrow . My dad said to call damn near everyday if I have to in order to make sure they got everything and that they are looking it over

[Auntie74 4]

That's very good advice. The surgeon's office said insurance companies will look for any reason not to pay, particularly since they are my secondary insurance. My primary doesn't cover at all.

Edited May 26, 2016 by Auntie74

[hazelzay 75]

Keep a detailed log of your phone calls, including the date, time and name of the person you speak with at the insurance co or their TPAdministrator. Keep copies of everything you send. Ask who specifically the information must be sent to, either by email or fax, and then keep the "receipt" from the email or the fax. Call 2 hours after sending to confirm receipt. Get the names and titles of each person you speak to. Make it clear to them that you will hold them accountable.

If you are in a plan provided by your employer (and your employer has more than 50 employees and is not a local or state entity) feel free to say something like "I really don't want to have to get an ERISA attorney involved."

Thank you for your advice . I called them again today to make sure they received everything . They said they resubmitted it and it should take 3-5 business days so I am going to guess next week . Because I also have to start my pre-op liquid diet next week . So fingers crossed ????????