Question re: why insurance deny

[az062217vsg 40]

For those of you who have been (unfortunately) denied by insurance, do they give you a reason why? I just submitted and am waiting to hear. If I'm denied I will likely self-pay, but just curious as so what insurance says in their responses.

[rosstheboss 21]

It depends on weather or not you initially meet the requirements if you do they may deny due to non-compliance. Basically you did not follow plan and did your part.

[az062217vsg 40]

7 hours ago, rosstheboss said:

It depends on weather or not you initially meet the requirements if you do they may deny due to non-compliance. Basically you did not follow plan and did your part.

My insurance has 2 options - a 3 month and 6 month option. We submitted at 4 months (yesterday). I'm worried they will say something like non-compliance, then I'll wait until the 6 month mark, and still get a denial for too low of BMI. If my BMI is the issue I hope they tell me the first go around.

[rosstheboss 21]

My BMI was too low also, I was on med for BP than Dr added a 2nd. Also I have arthritis in both knees, Eventually some day may have to be replaced. My Orthopedic Dr sent a letter also. Short blunt, (Loose weight or he may be in a wheel Chair)

I have been working out since the Band and have a tons of backup evidence of compliance which many people do not have after 8 years. So if BMI is low they want to see some co-morbidity factors. And that you have done your part. But it comes down to the person reviewing you case,

[OutsideMatchInside 10,166]

Honestly is mainly comes down to how good the Dr office is and how good they are at submitting. If they really know what they are doing they can get almost anyone approved. I went with a big program because I knew they could push it because they had a lot of experience and a large patient volume.

[Redmaxx 740]

1 hour ago, rosstheboss said:

My BMI was too low also, I was on med for BP

Same here. My BMI was 35 but with the high BP, the high cholesterol, sleep apnea and diabetes I was approved the first go around.