Denied!!!!!!!!!!!!!!!!!!!!!!

[WillPower 0]

G@# Da%# Mother #@$%^&( stupid Med-Valuless people screwed my chances to have it done this year. Now I have to appeal and pay $5,000.00 for my 2005 ded!!!AAAAAAAAAAARRRRRRRRRRRRRRRRRRRR!!!! AAAAAAAAAAAAHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH!!!!! It would have been paid 100% this year too!!! I was stupid to think that everything was going to go smoothly, they said that everything looked good...... I did everything that they told me to do and they still denied me. Some "doctor" said that I was not fat enough even though I can't tie my DAMN shoes!!!!!!! and that all my medical problems were not life threatening???? Then why am I spending $8,000.00 per year on medication if it is not life threatening!!!!!!!!!!

[leatha_g 4]

Darn! I'm really sorry to hear this. Surely there is an appeal process?

[Iluvharleys 15]

I'm so sorry that you were denied. Hopefully you can appeal and get approved soon.

[Zoe 6]

Will, that sucks big time. Strange, isn't it, how suddenly you're "not fat enough" in some actuary's eyes?

Please don't let this bad news wreck the season for you. If you're on $8000 of medication each year, there's gotta be a way to get insurance approval.

Take a deep breath and jump to the insurance forum here on LapBandTalk. Lots of bandsters had a horrible time with their insurance companies but eventually got approved, and many of them have shared their stories and suggestions on this board. I hope you find the tools you need to fight back.

[biggun 0]

That sucks so bad. You were so close...There is still hope, keep on them and they will surely approve you next time.

Kim

[WillPower 0]

does anyone know the website to send DOG CRAP through the mail!!!!!! They thought that COAL in their stocking was bad!!!!!

[La_madam 20]

When there is a will, there is a way..

I decided I wanted this so bad I went to Mexico instead of trying to fight my insurance. I sold my convertible mustang to pay for it, that is how band I wanted it..I have no regrets. I would probably still fighting with my insurance for approval 8 months later. Hang in there and Do not give up!

[DeLarla 22]

I got a loan from the credit union. The band pays for itself. I was spending a couple hundred a month on fast food but my loan payment is only $130. I gave up getting my nails done, home Water deliver, and my lawn service. If I can self-pay, ANYONE can. You just have to want it bad enough to figure out a way. Michelle would look HOT in her convertible now, but the Band is more important.

[Zoe 6]

Does anyone know the website to send DOG CRAP through the mail!!!!!!

I don't know if there's a dedicated web site (www.dogcrap.com?), but I have a reliable source for the stuff who will provide it free of charge. Before you go postal, though, Will, figure out an appeal strategy. If that doesn't work, you might have to join the ranks of us self-payers. DeLarla's right; the band does pay for itself after you calculate what you'll be saving on food, medications, and large-size clothing. But first think about writing a letter to your insurance company announcing that you are going to appeal the decision. Please read the insurance forum for suggestions.

[hagerteresa 3]

If you immediately begin the appeal process, if it is eventually covered wouldn't it all revert back to the day and time the denial or appeal took place? I have no idea on these things but thought I'd throw that out. I remember something about a bill I had for a broken ankle several years ago and even though I no longer had the same company when I got the bill, I had coverage at the time of the doctor visit. I would be on that phone talking to whoever I had to and doing whatever needed to be done immediately. I didn't bother even trying with my current insurance when I got my band. I just went the self pay route but only because I had someone who could lend me the money. If I had NO other options I would have fought my insurance. Good luck, Teresa

[Dawn_from_MN 0]

I was the first appeal in Minnesota with Blue Cross Blue Shield. The company that makes the band actually handled my appeal. I would find out why you were denied and talk with your Doctor about it. Maybe the company would help fight your appeal too.

Dawn

[HarleyNana 10]

Mamsi makes a point of excluding wls of all types in their contract. My dh just asked me if the ins paid for my surgery, I told him no, then he asked how much, I just said, less than any of your Harley's, that was the end of that...he has 5.

[Iluvharleys 15]

Pat - I love your comment! What else could he say?

[DeLarla 22]

And my husband took the opposite route. I had the band surgery, then he showed up with a new Harley. MEN!

[blossom 2]

Aahhh, CRAP!!! WillPower, I'm so sorry. Don't give up, though. Contact the insurance and find out exactly what the appeals process is and get started on it. Be sure you make them tell you in writing exactly the reason for denial. Be sure to thoroughly document every conversation you have with your ins. co. The new book by Dr. Ortiz has several suggestions regarding appeals including: Ask your surgeon to submit your appeal through the INAMED Hotline run by Weight For Life www.weightforlife.com. It's a free service for all lapband trained surgeons. Also, check out www.obesitylaw.com where atty Walter Lindstrom is known for helping people to get their ins. co. to pay for the surgery. Good luck, I will keep you in my prayers!