4Th Denial And Counting...

[sharonk 23]

Okay so just got word that i have been denied for the 4th time...Bah humbug!!

this time around i wrote my own personal letter to my insurance greivance dept. I asked them to reconsider their answer and also supplied more info on the req 6 month supervision that they previously have said there wasnt sufficient info on and i was going off the basis that my dr had resubmitted my bmi at 40. Originally my dr's office submitted all my paperwork at 39 bmi with hperlipidemia but that didnt qualify according to my insurance. So, my dr's office said they resubmitted my bmi as 40 and that would make me qualify. Well insurance is saying that nothing was ever submitted showing a 40 bmi. WTF!!! Xcuse my french.

Now i need to have my dr resubmit again and im sure ill have to wait ANOTHER 30 days to hear what im sure will be "denied".

Yep, i keep saying this is it, i'm not going thru anymore appeals and then i hear such simple reasons for denial, things that i can simply send in to correct and i try and try again. They make it sound so easy to just resubmit what they need but yet my life and health is on hold. Not to mention my 5 vacation days that i have held out for, for the past year, just in case i do one day get approved.

Ha, who knew at this point all i can do is let out a laugh and a shake of my head!

Serenity now

[bluetigereyes 95]

what about having your family doctor write a letter in addition to the surgeon...that typically is another way to get the insuranc company to approve you

[dhales 98]

Poor thing....what a long miserable process. I too love it when someone on the other side of the phone gives orders and doesn't really seem to care with no concept of reality or what consequences their oversight has on others. Hopefully this is the last time to submit....crossing my fingers for you!

[Imanurse 27]

i'm sorry - hope they can get papers in order for you.

dionaw- Sent from my iPad using LBT

[sharonk 23]

what about having your family doctor write a letter in addition to the surgeon...that typically is another way to get the insuranc company to approve you

i had already offered my family dr.s info and telephone #. Apparently now it's just the wrong info on my BMI which i thought was previously corrected on the peer on peer review 1-1/2 months ago.

[sharonk 23]

THanks dhales and dionaw! i actually just spoke to my band dr's office and i'm going to stop by there tomorrow and do a weigh in so they can get the 40 bmi put down on paper and then they will resend. I actually offered to do this back then but they never requested me to do it. i guess the next time i post a new thread will be in another month. Maybe, next time will be me saying holy crapola, i'm approved. lol, yeah right! i can only hope though!

hey, at least i'm at the point that i laugh, where as on the 3rd denial i broke down and cried my eyes out. my closest friend who i tell all this crazy stuff to wonders how i can not be freaking out on these people. i guess that's just not my nature.

[kbliss78 123]

I got so tired of all of that I decided to do a payment option and go self pay. It is worth it to me and important enough to me to make some major budget changes. However, I am lucky that I can do that. I cut some bills, changed cable bill, phones, and other stuff. It is going to even out money wise. It has been such a relief to be able to set dates and move forward without some stranger holding a denail stamp at this desk and not seeing me as a person needing help.

Best wishes.