Very Discouraged

[Slim2bnik 0]

My claim continues to be denied. First they needed the notes from my 6 mo med super diet. I had to send that twice, because they were playing games. Then they claimed they didn't have a psych eval. More games. Now they're claim the dr didn't put enough deatailed notes. I mean what else could he put in there beside my diet, exercise routine, I was even Rx'd weight loss medication. I contacted www.obesitylaw.com and I spoke to an attorney there who informed me that Allergan (the makers of the Lap Band) has an appeals program. The dr's office has to call and request the appeal form fill it out with my info, they then send it off to obesitylaw, to appeal to the insurance company. I was told the whole process will take approx. 60 days. They attorney also told me for my situation they have a 90% success rate and my appeal would mostly likely be approved at the 1st level. I guess that's sort of a silver lining:confused:

I try not to be, but I am very discouraged with all of this. I think its because of all of drama and stress I've had over the last 3 years (married, had a baby, cancer and divorce). My mind and body has really had ENOUGH. Now school has started back and I have 18 credit hours (I know its crazy but I want and need to graduate ASAP), and instead of recovering from surgery or at least preparing for it, I'm having to mess around with this whole appeals process. GRRRR! Thanks for letting me vent ladies....

[sxevan9 0]

I'm so sorry to hear you are being taken through so much drama. What kind of insuranse do you have? I thought as long as your BMI was 40 and you jumped through all the hoops most insurance companies processed the request within 10-12 days. Is it anyway you can ask your Nutrionist to provide additional information while you still go through the apeal process? Good luck and don't give up...

[Slim2bnik 0]

Thanks, I'm still going forward. I have BCBS of IL PPO. I've heard on msg boards and even my dr's office that this ins co is a pain to deal with. And yes that how it supposed to go. Jump thru the hoops, and Voila! you're approved. But thats not the case. They keep finding reasons to deny my claim. My Nut is supposed to amend the notes. However I have to track the Nut down. Which is another source of my aggravation, having to chase people. I'm also going to write a letter chronicling weight loss attempts.

[aprilapple 1]

I have read about BCBS of IL on the message boards. I am so sorry that this process is difficult for you. Especially in light of the personal issues that you have had to deal with in the past 3 years.

File the appeal! Don't let them take the fight out of you. I read somewhere that they hope that you give up so that they don't have to pay.

Also, go ahead and register for school. That will help you to stay busy while the appeals is being processed. I will be praying for you. Please keep us posted or just vent if you feel the need.

[*slim* 2]

I am so sorry that you are going through this. File that appeal and also call Blue Cross. I have read at least one post where the person just kept calling them about why it was denied and they just went ahead and approved it without the appeal. They do things like this in hopes of you giving up. Don't give in to that. You have insurance for a reason. They are supposed to be there to help. Keep bugging them until they know your voice when they hear it. I know when my information was sent in, I called everyday. That's what they get paid for, to be of service to you. I wish you the best with all of this.