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notsuccessfulyet

Gastric Sleeve Patients
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Everything posted by notsuccessfulyet

  1. notsuccessfulyet

    Denied- Should I be calling my Insurance Co?

    What was the reason for denial? When I was denied, I called everyday and had the representative quote to me what my benefit read. Sometimes it can take up to 30 days for an answer I was told. Be persisent and you will win. Just make sure each appeal is well documented and have your doctor appeal on your behalf. It took me 3 times before I was approved. They are hoping you give up. Good luck
  2. Just wanted to say . . . . never give up. After 5 weeks of back and forth with UHC peer to peer and 2 denials, I have finally been approved. Got my pre cert and surgery date for gastric sleeve 8/25.

    1. gbb77901

      gbb77901

      Congrats! Way to be persistent and strong! Your health will thank you!!!

    2. barbb3

      barbb3

      Good for you! actually GREAT for you!

    3. Domika03

      Domika03

      Perseverance paid off, congrats!

  3. notsuccessfulyet

    Insurance help

    Hi I also have UHC with a self funded plan. The policy states you must be over 21, have a BMI of >40 with a 5year medical history of BMI> 40 or BMI of 35 + 2 co morbidies. I have the 35 BMI with 5 co morbidies and am currently on a 2 level appeal. Make sure you check the fine print of the WLS exclusions. I'm told by many that usually after the 2 level appeal they change their opinion and give you approval. Fingers crossed, I hope so. I have already done the pre op, psych eval, nutrition and surgeon consultants and pre op diet and was denied my pre cert 3 days before surgery. Thank goodness my surgeon is fighting for me. Hope you find what you need to move forward.
  4. notsuccessfulyet

    I knew I shouldn't have said anything!

    I'm sorry to hear about your experience with your Water aerobics instructor. I too, have been taking water aerobics for more than a year 4-6 classes a week and have not been able to lose the weight. I have to bite my tongue not to mention it to people like those at the Y who often discourage weight loss surgery. I have been denied surgery and am currently waiting on a reply to my appeal. It is very frustrating to have people look down on you after you've done the research and the work prior to your decision to try and loss the weight and finally think you've made the right choice only to be greeted with such negativity.

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