i won my appeal scheduled for 4/28

[sleevegenie 0]

i am completely amazed, i have been in appeal for so long my insurance, anthem blue cross of california denied the sleeve saying they consider it experimental. i requested an independent medical review and i won, drs office called today to schedule and i have surgery in two weeks, holy moly, i am so relieved, i have been so worried and now i have to do the liquid pre op diet, doesn't sound like much fun, but i am there, will be going to the store tomorrow to stock up, so glad i didn't settle and do the bypass, i knew that this was definately the surgery for me, so i think i am still in shock and i cannot wait for this two weeks to pass, thank goodness they :thumbup::thumbup1::biggrin2::cool::wink0:

scheduled it so soon,

Edited May 15, 2010 by sleevegenie
thanks mimi me, i meant 5/28 very soon

[MINI-Me 196]

Great news. I'm assuming you meant 5/28? Not much time to go at all!!!!

[wannalise 15]

YAY!!!!! That is so exciting. Good for you. Keep us posted you'll get through your preop just fine!

[Maddie 9]

That's amazing! Good for you pushing for the appeal. Gratz. Best of luck.

[BandMomsRock 0]

Congrats. That's awesome. I'll be having mine about 2 weeks behind you. Good luck, it gonna be great!!

[Lillie24 2]

Congrats... I know you must be exstatic

[SParkle 4]

Fantastic news - and not long to wait for it either now!! Good luck - let us know how you get on.

Kathy

[KabinKitty 10]

Congrats! Sounds like BC/BS is finally coming around!! I also have Anthem BC/BS in Ohio. I just started through the hoops. The earliest I could have surgery is Sept. 2010.

My surgeon (even if the ins. co. doesn't require it) has each patient go on a 3 month diet to lose at least 5% of their body weight. At the seminar yesterday the nutritionist said she will not okay us for surgery if we don't do this. :001_tongue:

This weight loss center (at Wood County Hospital) has a stellar record and has performed bariatric sugery since 1978. :thumbup:

[carolyn24seven 11]

Congratulations! I wish you the BEST on all phases you will be going thru. It is a fantastic journey. I love my sleeve. Keep posting. You will do well!

[Missnursette 1]

How do you get an independent review? I am scared I wont be approved for VSG because of it being considered experimental.

[CoachKK 0]

Congrats! If you stuck it out for the appeal, I know you can do the pre-op! Hang in there!

[Tiffykins 672]

Hey Chickee, I'm so happy that you've won the appeal and have a date set. You deserve it, and can't wait to read all about your surgery.

[sleevegenie 0]

what insurance do you have?? i live in CA and here if you are denied d/t experimental or maybe for any reason you can go to the state they have the dept of managed health care and you can request an independent medical review, they assign your case to 3 doctors who review your case, read your appeal letter and decide if the denial is fair or not, if the vote in your favor the insurance company has to pay for your surgery, i am so blessed, so happy but i think each state may have different laws, you should probably contact the state insurance commisioners office, best of luck, let me know if i can help in any way, i think really that they will all start covering it soon, they will probably outlaw the band and start doing the sleeve, much less problems, jeani

[sleevegenie 0]

lol, good point, thanks

[Missnursette 1]

I actually have Aetna right now and am on my 2nd appeal with them... July 1st we are switching to Anthem BC California. I don't know what else to do with Aetna before switching, cuz they are one of the 2 that pay for VSG! I live in Louisiana.