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Denied a 2nd time



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Well I official Hate Blue Care Netwrok. They denied my initial request & then they denied my appeal... for one reason only. They said I didn't see a Doctor for 1 full year in a row about my weight loss. Even though I had gone to William Beamont for 6 months on a liquid diet & another Doctor for 4 mnths on Meridia they say they weren't in A ROW. LOL Who sees a Doc for weight loss that often anyhow? You usually go to a clinic like weight watchers or Jenny. I only see Doctors when I am in pain not for them to track my weight loss or gain. Also when I was losing I wouldn't go to a Doc - what for? I was losing - no reason to go!

I feel defeated. I feel anger & sadness. They say I can second appeal from the Doctor & I can do a 1st appeal & then a second- But they say the process will take several more months!!!! I have been at this since fricken OCTOBER 2004. They are simply making it so I quit & self pay!

Whewwww- had to vent!

Well I think I will try if possible to arrange a self-pay- but if I do I won't say that they insurance Company won- I will say I did- I got my band! & I will still try after to get them to pay. Lord it should NEVER Take this long just to get a "NO". I feel like I wasted 7 months already & for nothing but more stress & aggrevation.

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(((((((((((((((Christina!)))))))))))))))))

And what the hell does "in a row" mean anyway? And you are one of the low BMI folks too. I'm sooo sorry!

Yeah, insurance companies have turned agravation into an art form. This is my stupid insurance company example: I was driving home from my folks' place when I noticed the back door wasn't shut all the way, I got out, put my hand on the door to push it shut and somehow in the process I hurt a tenden in my thumb.

I went to the DR, she refered me to a hand specilaist, but it too 2 months for them to approve the request. When I fianlly did get in to see him, he said I should have been in a cast. To add insult to the injury, the insurance company denied my claim, saying it was a CAR ACCIDENT and that I would have to have it paid by the car insurance policy. That insurance company just laughed at me.

I forget how I finally paid the bill, but still!

I can only imagine how frustrated and pissed off you are. (((((((((((((((((hugs!)))))))))))))

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I had blue cross blue shield and they were never going to approve me-they told me same thing about the doc for one yr-which I had-I actually had 2 straight years but they denied then denied again-the nurse had told me they had NEVER approved anyone for this thru my company or union but it didnt hurt to try.Good Luck.Fuuny thing for mine was when I decided to selfpay instead of going thru the high interest rates of the finacing companies-i got back from Tijuana and had an approval letter from a company that was going to do it 90 days same as cash!!!Figures.As usual Im a day late and a dollar short-was a bit tough getting 2 RT tickets and 9k in 4 days but thats what CC are for right?lol

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I am so sorry to hear that they denied you a second time. I cannot believe they will not accept the information that you have on the docs. But then again since it's the insurance companies I do believe it..'

Sorry Sorry

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Christina, your insurance company sucks. I hope you don't have to self-pay, but if you do, welcome to the club. Eight months after my surgery, I say it was worth every cent.

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:{{{{{{{{{{{{{{{{{{Christina}}}}}}}}}}}}}}}}}}}}}

Awww that sucks big time. Keep us posted on the outcomes. WHen you getting banded? Where? Who? You know all that good gorey stuff we love to know.

HUGS again

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I don't understand insurance companies....actually, I don't think they understand themselves and that might be half the problem!!!

Christina...Above your name it says "I'LL SUCCEED"!

I say go for that 2nd appeal.....

Good Luck..

Margo

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Hey Christina,

Sorry about the denial. I know it is terribly frustrating. I had blue cross blue shied for probably 18 years of my life and they would never cover ANYTHING weight related. The college finally switched to a different insurance company and I thought it might be more hopeful but NOPE they stink too. I feel like my insurance company should be paying me more money since my blood pressure has dropped dramatically and I'm getting more healthy overall. Trust me, anytime I get the least bit sniffly or anything I'm not going to hesitate running to the doctors. I'll let them pay for a few extra visits... Screw insurance companies!!! What a crock they are. Anyhow I never bothered to fight with them for my band. I wasn't going to fiddle fart around about it. Fortunately my father in law helped me pay for mine and if he hadn't I probably would have fought it more but I just wanted it done. Keep your chin up darling and hope things improve. Best wishes, Teresa

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Thanks ALL of you - I just love LBT! Zoe- Girl you said it - "They SUCK" Penni- I am trying to finalize who is going to do it & when has I type this:) You know you'll be the first to know. I should know more when I get back w/Mom. Teresa, Bubba & Vines & Everyone thanks for the support. Too bad we all didn't live near one another & we could STORM THE BUILDING! LOL LOL

I am supposed to hear back from them (BCN) Sometime this week with the medical reason of"seeing a Doc for a year". Whatever @#$%%^^ - Like I care what the reason is-LOL LOL I just want a dam "YES-APPROVED"

Hey y'all go check out my wedding dress for sale in the "Lounge Area" Tell your friends maybe they know someone getting married:0) Thanks for the idea Penni!!

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Christina I'm so sorry you got this bad news again. I wish you lots of luck and I hope you will be able to self pay and get your band. I know that whatever happens you will become the healthier you that you so deserve to be!!! (((HUGS)))))

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