I just got denied a 3rd time! I dont know what i want to do at this point. Im angry sad confused! Finally emotionally drained at the thought of appealing on my own behalf, which insurance said i could do.

I called the drs office and told them i would like to come by and pick up all the documents that were submitted. They told me they will have to put everything together and will call me next week when its ready. Wait, why isnt it ready now?! Wth?! Didnt they just resubmit my info this week?!

I dont get it!!

I started at 39 bmi now im 40 bmi so i dont need the comorbids and my dr office states that the 40bmi is what was submitted this past week for the dr on dr review. ive done my 6 months, pysch exam, test, consults. Trust me when i say i have done EVERYTHING my insurance medical policy has stated!! Ive read it a trillion times!!

I cant get an exact answer from insurance rep because the info hasnt been entered into their system yet. So basically im back to waiting and trying to figure out in my head what it could be. Maybe my drs office has something wrong?! I dont know?! They did seem a little weirded out that i was requesting all the paperwork but hey this isnt their life so why would they be as particular with the info, right?!

Any who, im going to TRY not to think about this too much over the weekend maybe a few drinks will help me forget. i think i will review my packet and then decide from there what to do.

Thanks to those out there in band land listening to me vent! I pray others have better luck than me.

Thanks tracy...im going to gather up the documents from my drs office so i can see exactly what my insurance is seeing! My guess right now is the paperwork is the problem bu i will keep this info handy!

Reading your story seemed like a repeat of my own. I jumped through all of the hoops that my insurance company wanted. For 2011 and 2010, my BMI was 40. However in 2009, I had a 39 BMI. My insurance (BCBS) only accepts high blood pressure, sleep apenea or diabetes as comorbidities. So adfter the 6 months supervised diet, etc. I was denied. Then denied again. They even denied obesitylaw. However during this time, we calculated that if I finished my last 6 month diet at the end of January 2012, then it would be a new year and the 2009 weight would not be counted. So the whole time through appeals, I worked with my surgeon and my family physicians office to start a new 6 month diet. The only catch being, I couldn't lose "too much" weight or else i would drop to 39BMI and be denied again. After my last January weigh in, insurance approval in 3 days!! I had my lapband surgery last Thursday. Keep hanging in there!

Oh wow, good for you for sticking with it. I just mailed a letter to the appeals and grievences dept with my insurance company and i included the same 6 month diet write up alomg with my own write up. Im sure they will disregard mine but i figured it was worth a try. I just hope it doesnt hurt my case...you never know with these people! I also will have one more shot at a peer on peer appeal once my band dr comes back from vacation which is in early april. He agreed to try it again since he nevwr even had the chamce to discuss my case in full. Im keeping my fingers crossed but im also not getting my hopes up.

Have you got your paperwork from the surgeon's office yet?

I ended up only getting the 6 month write up because thats what insurance is currently denying it on.