Denied!

[Longleggs 11]

When I originally started to consider the lap band surgery I figured I would call the most popular place out there (in my area, the 1-800-GET-THIN) and let them direct me to the appropriate place. They went ahead and checked my insurance and told me I was "pre-approved". Now 8 months later, been through 4 sleep tests, EGD, blood tests galore, 6 months of dietary counseling, and minus a gal-bladder.

This past weekend I got a denial letter saying that my surgery was not medically necessary, which I got a bit irritated with because how can a person sitting behind a desk that is only seeing 6 months of history know what I need? Then yesterday to my surprise I get another letter of denial letting me know that I can not have the surgery because the doctor is out of network! Shouldn't the folks over at the center for weight loss seen that when I originally came in and "pre-approved" me? I am fustrated to a level that I am ready to call it quits and just go on the rest of my life being super obese and die at an early age of heart disease or cancer like my parents. I need words of encouragement or advice of some kind PLEASE!!!!!!

[Secondchanceatlife 38]

Before you give up, call your insurance company and talk with someone. Sometimes it's something that is an easy fix.

I wish you lots of luck

[mufasas-mom 170]

I'd call your insurance company and get the EXACT qualifications yourself - not the doctor's office - then go to your insurance company's website and search for the doctor's which ARE in your network - get all the documentation and paperwork from the place you just spent 8 months with - and bring it to a new doctor's office that's in your network.

i cannot stress enough how it's the PATIENTS RESPONSIBILITY to obtain all the insurance requirements and be on top of things - this is a very important step you are taking for your health - why would you leave that up to some morons in a doctors office....

let us know what your insurance company says.....you may have been denied in the beginning from something simple like missing paperwork - you must call and speak to your insurance company rep. - look on the back of your insurance card.....

[bluetigereyes 95]

I would also check with other doctors. I have heard alot of negative about 1-800-get thin.

[PattyGirl66 1,243]

I agree with Bluetigereyes. I have heard horrible reviews about 1-800-get thin.. PLEASE PLEASE do your research! GOOGLE is your best friend to find answers.. READ this recent article.. there are tons more!!!

http://articles.latimes.com/2012/jun/13/business/la-fi-get-thin-lawsuit-20120613

[TreehouseLady 11]

You will be glad you were ultimately DENIED this go around - believe me - you are being protected. Players in this are still operating, so buyer-patient aware.

Please read this Class-Action Lawsuit in its entirety.

http://www.1800getthinclassaction.com/sites/default/files/Whistleblower%20Complaint.pdf

[xsentrick 194]

I pretty much agree with everyone else. Call your insurance provider directly and ask lots of questions. Then you can work towards whatever requirements that have set. Good luck!

[readytogoforit 172]

my insurance people made a recommendation of who to call. I was glad, what do I know?

I went to the U of Minnesota and couldn't be happier with the care & guidance. It is really important to get someone who has lots of experience.

I think we have seen a report on this forum about the one you first picked. Scary people, get 'em in, get 'em out.... all about the money not trying to help.

Don't give up, talk to someone. Best of luck to you!

[Longleggs 11]

I am so thankful for everyones advice and especially the information on the 1-800-GET-THIN scam artists! I have called them and requested all of my medical records be sent. They are being a bit difficult but I do have a fabulous laywer and I doubt they want a call from him. I am now going to call my insurance company and have them give me the name of someone in network that will hopefully consider everything I have already been through. I will keep everyone posted!

[mufasas-mom 170]

good luck - i'm sure the insurance company will be able to direct you to a good surgeon in your area. I hope the place sends you all the medical records.....that is so awful about that 1-800 place....

[downhomechik 41]

If you have a good regular doctor ask him for a referral to a reputable place. Good luck with all