ising4godinohio
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Posts posted by ising4godinohio
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I am using the calendar feature on my phone to remind me when to eat, drink, and take my meds
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If you have strongly documented history of sores, infections, rashes, and methods used to treat them as well as the outcome, you may have a solid foundation to appeal. Also, carefully read the denial letter. It will tell you exactly why it was denied. It should also tell you what your options are to appeal. It may be something as simple as your doctor needing to request a peer-to-peer review.
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It's out of Iowa. I have tried several times to find out what I needed, and the surgeon has also tried to get a straight answer, with no luck.
Go to their website. Look for a link that says providers. Click on that. Depending on the site, you might need to enter the state your policy is out of and click enter. Once you enter the provider portal, look for something that says medical guidelines. Then look for a way to search that part. You might have to click around a little. Once you find the search tool, enter bariatric and click search. That will bring up their specific guidelines for wls. However, please be aware that if wls is a stated exclusion the odds of getting approved are extremely slim. Unless your policy is through a self funded employer. Then you might be able to get the employer to ask for an exception
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I use unjury unflavored instead of GENEPRO. I think it dissolves better and it has significantly more Protein
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If you call your insurer, you want to ask if wls is a stated exclusion . If so, you want to ask if their medical guidelines offer any criteria that can override the exclusion. Also, if your employer's plan is self funded you can ask your employer to request an exception on your behalf
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Also, if your employer's plan is self funded, you might want to try to talk the employer into intervening on your behalf. The employer can request the surgery be approved if you meet medical necessity
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Going back to school
in The Gals' Room
Posted
Congrats! I'm 51 and finished an Executive MBA last year. I'm now taking a post graduate certificate class. Being an adult student is a challenge but so worth it! Good luck!
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