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Got denied:(

Apparently my insurance company denied it, saying that the surgery wasn't covered. My the surgery center says it is and that they have a reference number or something from when they talked to them the first time! They said not to freak out and they have already filed an appeal. I guess it has something to do with codes and it being weight loss vs medical necessity? Idk, but very frustrating!! Especially since I've already been jumping through their hoops for 6 months now!

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What insurance company are you with?

Hopefully it was just a simple mistake, and you'll have that approval very soon!! Hang in there!

  • Author

Regence blue cross blue shield

Hang in there. The fact that the office is already filing the appeal seems to be a good sign.

  • Author

Thanks guys! And yes, I am so glad that my surgeons office seems so on top of things. My last appt was on the 9/12 and the appeal letter was dated 9/16. So that part makes me feel better. Unfortunately I feel like this is my last option, and this is what was gonna make it finally happen for me. So I am feeling fat, depressed and defeated

Have you checked your policy? Give them a call yourself to be certain it is covered. Or look up your plan brochure online.

  • 3 weeks later...
  • Author

Just wanted to give you guys an update. It was actually covered so they closed the appeal and opened a new case. They denied the new case because my 6 month pre op diet was 159 days instead of 180 days. Seriously!? So, today I'm going back for what really will be my last msd check in! Then hopefully it won't take much longer to get approved as it is an ongoing case! Hopefully...

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