copgrrl2009

UPDATE WITH A HAPPY ENDING!!!! After 2 denied appeals - A denied peer to peer. Changing Doctors, Stressing my self out to the max........... I get a call out of the blue from UHC last week advising me that they were approving my surgery. WHAT?????? YOUR KIDDING ME??????? I have been trying since June, phone calls daily...........And then, when I least expected it, Bam - I was told that because I was misqouted information numerous times...... They were approving me. Not because of switching Dr's - Not because of sufficient 5 years medical history....... Because they made a mistake. Props to UHC for taking time out to investigate what I had been trying to get accomplished for 3 months. I cant even begin to tell you how happy I am. I know that everything works out for a reason, and maybe this was God's way of havingme switch Dr's. I don't know - But I'm approved!!!!!! And should get surgery date next week!!!!!!!!!

Ok - So i started this journey 2 months ago. My insurance plan only requires 35 BMI with 2 Comorbilities. They also want 5 years of weight history. I have a BMI of 39, obstructive sleep apnea, acid reflux, hypertension, restless leg syndrome, irritable bowl syndrome, etc etc etc.......... I provided my dr's office with all my records and was told I should have no problem getting approved! We even started my liqued diet. My insurance company told my Dr's office patient meets all needs for surgery. Yay right?? 1 hour from pre-op we find out that I was denied. So, the nightmare begins. First we were told it was because I had to have a BMI of 40 or above and that was the reason for denial. We found out that Clinical services copied and pasted the wrong information over and that was the info they were going off of. Okay, this can be fixed Right? Wrong - my Dr does the PEER to PEER and was again told the same information. At this point I am calling daily trying to get this fixed. Last week, they set up an urgent appeal because i was told that it was their mistake and that it was the quickest and only way to get it fixed. So, I sit for several more days driving myself crazy waiting for the call. yesterday, I recieve a call from the insurance company telling me this time that it was denied because they didnt have enough records for the years 2007 and 2008 and need records from 2006. OMG. I had a hard enough time getting them the records I got them due to everything being switched over electronically and I have no idea who i even saw in 2006 if any Dr so because of that I cant have surgery? I need advice? I dont know where to go from here. HELP!!!