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Insurance appeal

Hey all:

My insurance company requires 6-months of dietition aide after all the other apts (sleep study, ekg, physical therapy, etc). They said that they would submit it, it will be denied and then they can appeal it so I could have the surgery sooner. Does anyone have any experience in that? How long did it take after your appeal process? Is there a way to check the status on an appeal?

thanks for any help. I am new to this. :)

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Hey all:

My insurance company requires 6-months of dietition aide after all the other apts (sleep study, ekg, physical therapy, etc). They said that they would submit it, it will be denied and then they can appeal it so I could have the surgery sooner. Does anyone have any experience in that? How long did it take after your appeal process? Is there a way to check the status on an appeal?

thanks for any help. I am new to this. :)

My insurance company also required the 6 month supervised diet. I was going to go your route because I am diabetic, High Blood Pressure and a little over 100+lbs over weight. I didn't want to do the 6 month thing. But I talked with the doctors office and they said it will be denied if I don't do the 6 month, they said we could appeal it also but it would probably not come out to anything. So I just decided to do the 6 month thing and then turn it into insurance. I personally couldn't handle hearing of denial from Insurance company so I just did it their way. I know it seems hard to begin this journey, but it does go fast. You can try it your way and see how it goes and in the mean time start your supervised visits anyway. The doctors office turned in the paperwork on March 21st and I was approved on March 29th, its was so fast. I am scheduled for surgery on April 29th. Good luck to you on your journey.

First off good luck with everything!! I had to do the 6 months of weigh ins BUT at first I was told by my insurance company that I didn't have to but when my surgeon's office sent everything in all of a sudden I had to have 6 months of weigh ins. Instead of appealing I just did it and honestly it was over before I knew it. Hope everything works out for you though.

I was denied based on my sleep apnea being a "correctable" condition even though my BMI was 54...I was told since that was the only reason they gave they could not come back in an appeal to require the 6 months supervised diet...anyway so my denial was different but it took 1 week from denial to sending the appeal then another 2 weeks to hear back on an approval. I only 1st knew it went thru because I peeked at my online insurance page and saw "approve" for preauthorization for surgery. I know another patient got denied the same day I id because she or he had never tried prescription diet pills. My insurance basically denies everyone for SOMETHING then the appeals usually go thru.

Good luck! Keep in mind that if you do need to do the 6 months of supervised nutrition, although it seems like forever, it will go quick and will ultimately help you in this journey. Just don't give up...like insurance hopes people will! ;)

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