Denied by Insurance... :(

[AshleyRN 0]

I just found out today that I am denied by my insurance company. They sent out the letter yesterday and the lady I talked to on the phone couldn't give me much information. I'm so sad and disappointed right now. Not only have I failed in being healthy, but I can't get any help from insurance to help me get there. I have Wellmark Blue Cross/Blue Shield of Iowa. We'll do an appeal, but the lady that does all that is out of the office until Friday. :smile: I had all my time taken off work, and now I have to try to fill in spots at work & hope that I can still get some time off when/if I get approved later on. I've just lost all hope today and really needed to vent. I need this surgery really bad.

[meschultz 0]

Ashley.. I am sorry you were denied.. Don't give up hope just yet.. That is why they have an apeal process.. Best of luck to you and I hope it all works out.. Stay focused

[VEEJEE07 0]

Ashley, I know this must be so dissappointing but wait til you know the reason. If the insurance co can't give it to you over the phone they may be able to give it to your doctor. It may be something that is minor ( just a small bit of misinformation can throw it off) so just wait and see. Let us know how you make out. I work in the insurance industry ( not health ) but nonetheless these things happen and then get corrected.

Good Luck

Keep us posted

[BootyBee 0]

Hello don't give up i to was denied at first and had to do an appeal and go thru 6 month supervised diet but this is some thing i wanted for me i'v been going thru this before Feb/08 but happy to say i will be banded on 10/22/08 so just hang in there IT TO SHALL HAPPEN FOR YOU.

[ncsoutherngirl 0]

I have Blue Cross and Blue Sheild of NC. I was denied my first try and I also wanted to give up. I was denied on a Friday and got my letter in the mail. I had to wait until Monday to call the drs office. Really I had given up. Finally the drs office said I was denied because they needed a 2003 weight and the Psych Eval had to be rewritten because he didn't address if I could mentally handle the surgery. This was done and sent in. The way my luck is I just knew I would be denied again but I was approved. Don't give up. It may be just a few small things they need. Good Luck and let us know how it goes.

[nrmanning 0]

Don't give up. I know that is easy for us to say because I can only imagine how you are feeling. I started this journey in Feb/March of this year and after being denied, appealing and being denied again. I gave up. A good friend suggested I use the dr another friend of hers had used which is where I was going to go at first but decided to go to a different dr. Anyway long story short, this new dr is a patient advocate which means his office works to get you approved and will keep trying until they can't try anymore. I was approved last week and my surgery date is 12/4. I have united healthcare and like everyone else says, DON'T GIVE UP. Pray and be faithful that this is the answer and everything will work out.

The interesting thing is that the reason I was denied was because they said I basically was not sick enough (have high blood pressure, sleep apnea, depression just to name a few). My primary care doctor sent a letter with my five year history but UHC said that was not sufficient. So I was told by the second dr to get the actual pages the dr writes their notes on and send that in and presto I was approved within a week.

So like someone else posted, find out what it is and work it girl!

[Cocoabean 430]

Hi Ashley, I have BC/BS in California, I had to appeal just to see my surgeon for a consult. I won the appeal as have many others here, don't give up! It often seems to be standard procedure to deny, deny, deny!! I took advice from "Weight Loss for Dummies" they have a good appeals letter format. I followed it and added some of my own information. It worked.

Best wishes,

Denise

[JamieNP 20]

Don't give up. I got denied because I was 6.5 lbs under the weight requirement. I gained the 6.5 lbs and got approved! Had surgery 2 weeks ago.

[AshleyRN 0]

Just wanted to let everyone know that I got approved by my insurance company (Wellmark Blue Cross/Blue Shield) after I sent in my appeal!! :tongue2: I'm so excited!!!

[adagray 1]

Congrats to you! :tongue2:

[Mrsace13 0]

Just wanted to let everyone know that I got approved by my insurance company (Wellmark Blue Cross/Blue Shield) after I sent in my appeal!! :frown: I'm so excited!!!

Great, that gives me hope. I'm going through an appeal now. What was the reason they denied you?

[ncsoutherngirl 0]

Yahoo!!!!!I'm so happy for you. Good luck and let us know how everything goes.

[Weigh2Fat 0]

AshleyRN!

YEAH! I know how frustrating it all is. I was denied 3 times before finally being approved. My BMI was a fraction of a point lower than the required 40BMI. I had to jump through hoops to get a new actual height measurement instead of the height measurement they were using from my medical record that was over 20 years old. My persistance paid off and I'm so glad! Good luck!

[Cate18 0]

I also got denied by Wellmark BCBS of Iowa because I'm a grad student at UI and they insist that any surgery I have get done at UIHC. But UIHC only does gastric bypass, not lapband. They told me it was all the same to them and they didn't care which one I had, but if one was offered at UIHC I had to have that. So no lapband for me on Wellmark.

Now I'm on my husband's insurance and having to pay 1/2 out of pocket. Just curious--I'm guessing you're an RN at UIHC (I may be mistaken). They didn't fight you to have gastric bypass instead ? If so I'm calling shenanigans on the mean insurance man that was so rude to me when I appealed.

I'm very happy for you though ! Congratulations ! I hope it goes incredibly well for you.