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Aetna Medical Director Denied Dr Terry Golash

  • Replies 9
  • Views 2.7k
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Did you get a report on your psych eval from him? My psych Dr sent me a copy of what he sent my surgeon. Matter of fact, I think they're required to.

Maybe he denied you not b/c of health issues but more maybe he thinks you do not understand the changes you have to make with the lap band. Just a thought. Good luck with appeal I hope it works out for you!

My psych denied me for lap band, but Tricare still approved the procedure. Psych said I needed to work on my depression issues and possibly change my meds.......then I should rethink lapband. Well, since I have lost 50 lbs WITH the lapband my depression is slowly improving. Most of my depression was caused by my weight. I feel so much better about myself and the I look! I am not saying I am cured, but I am definitely getting better.

Medical professionals often don't consider the big picture...and I agree that much can get lost with the "rubber stamp" approval process. Being that you are in a medical profession, the coverage for the uninsured comes with the territory. I also did a great deal of pro bono work when I was in active practice.

I don't know what your situation is regarding the possibility of retaining an attorney...but there are some whose professional focus is strictly to interface with insurance companies. Sometimes the "threat" of getting an attorney involved may be enough to have your case reviewed with "a fine tooth comb."

Good luck...I sincerely hope that you win your appeal.

Dont think its necessary to mention minorities, they did not deny you!! Your case wasnt not properly presented therefore it was denied!! I am a registered nurse and provide service to bariatric patients who are approved by medical and end up being noncompliant and are gbgb's!!

Sounds like the psych md denied you because you seemed mentally unstable.

  • Author
Sounds like the psych md denied you because you seemed mentally unstable.

Why thank you for your "professional" opinion SandraO. Much obliged.

Your welcome : )

  • 3 weeks later...

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