Upset today and I don't know what to do.

[candiecane 3]

I had a date set for October 28th now I get a call from my surgeon office saying that my insurance thinks that I am not medical nesercary for the surgery. I have bmi of 38, I have hypotension, I have type 2 diabetes, I was just diantnose with sleep apnea. What else do they need. I then called my insurance and they said that they denied my due to that they did not have my cardiac release and a xray. I am starting to think that even if they send in what they need they might still think they it still not medical nesercary. Did this happen to anyone else. I'm at the point to stop this diet that they made me go on and just go back to eating and have to deal with feeling sick all the time. I just don't know what to do anymore.

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[Havasumoma 250]

Get your surgeons office to help. I've heard of the doctor calling insurance and talking to them directly. This sounds like an easily fixed oversight.

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[candiecane 3]

I hope so. Thank you

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[cbonet 336]

Get the items requested as soon as possible. Cardiac clearance is mandatory especially with sleep apnea. Get the referral from your surgeons office and make the appt. Mine was a nuclear stress test done in 2 days with a follow up for the results. All done 3 days in a row.

Good luck to you

[James Marusek 5,244]

Keep fighting. Most of the problems that I encountered with the surgery came from my health insurance company.

[Barryindiana 9]

Hope your surgeon is better than his staff...

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[QueenOfTheTamazons 634]

I was denied as being not medically necessary when i had a bmi of 55, sleep apnea, diabetes, arthritis and high cholestrol. Obviously it was medically necessary. I think most insurances need to deny first. When we argued they said it was because i had not completed my 6 months of medically supervised diets. I called and called the approval department, submitted a letter from my pcp and one i wrote describing my diet history and family history of disease.

Since i figure the insurance would pull the same thing with my husband, we preemtively wrote a similar letter and got the pcp to write one for him as well. My husband's insurance was denied as well, saying that he didnt have a cardiac clearance.

Push back. Find out why and prove them wrong.

[candiecane 3]

Thank you all. I will call my insurance asap. I got a cardiac clearance last week and I think I have to get it myself and hand deliver it. Now I have to go tonight for the sleep apnea. And hope they can give me the clearance asap.

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[teedsg 253]

Good luck,

I hope everything works out for you. Insurance companies can be very cold sometimes, but, I hope you gave them everything they need. Let us know when you got the approval.