My Appeal worked!!!!!!!

[Eureka-C 20]

OMG! I am on top of the world. I have been waiting what seems like forever. I first started considering surgery and researching my options back in February after my latest diet failure on Alli and reaching my highest weight ever. :sad0:I went to some seminars in April and May, but was still unsure which surgery I wanted. I finally went to the BSC in Dallas with Dr. Davidson (I had avoided his seminar because it was not free) and had a complete health screening along with a group information session and one-on-one session with the insurance coordinator, as well as a one-on-on consultation with the RN. Of course, I also met the surgeon. I loved the way they did things and completely answered all my questions. I decided on VSG. :001_smile:They applied to my insurance for approval for all three surgeries, and I was approved for RNY and band, but not VSG. (Insurance is BCBS CA even though I am in Dallas) I had a long cry :crying:and decided that if I could not have VSG, then I would wait, because I didn't like the other surgeries. My husband told me to research a loan, and I did, even got a loan approved. I decided with some support on here that I could appeal. If I lost the appeal, then I would do the second appeal (IMR), and only if I lost that would I get a loan. I set myself up for a long wait and soon was depressed, :sad0:quit trying on the diet the RN set up with the nut for me. I appealed, but did not get my hopes up too high. WELL...... Today was the 30 day mark after my appeal, so I called the insurance. The person who was over my appeal was out on vacation. ARGHHHH!! I told myself that I wasn't going to give up. I would keep calling until somebody answered my questions. I called the number she left as a standby on her voicemail. That person was out of town as well. So I called the number she left as a standby on her voicemail. Finally I reached someone. They looked up my file and said I WAS APPROVED. I won the appeal. I cannot believe it. The letter was mailed on the 28th so it should be here today, tomorrow or Monday. I actually screamed when she told me, then I told her. "I love you! Thank you!" I can't believe I said that. It just came out. Thank you to everyone out there that said to keep trying and gave me copies of their appeal letter. A copy of my letter is on my blog at From Thick to Thin

[mp8btpc 32]

THat rocks! So happy for you. Congrats

[GayleSBennett 0]

Congratulations! That is excellent news. I can't wait to hear about your future success with the surgery.

[M2G 1,836]

Congratulations! That is wonderful news!

Everything on my "list" (from the surgeon and the insurance company, UnitedHC) will be CROSSED off on Tues. Oct. 5th, and then subsequently submitted to the insurance company. The sleeve IS covered (after we pay our high-deductible) and I've been in touch with 2 different coordinators for the last 6 months, so my fingers are crossed that I will be approved in a few days after submitting and hoping for a surgery date shortly after approval. I have not prepared myself for possible denial, so I don't know what I will do.

But after hearing your story, I'm SO happy for you and glad you are sharing it here, for others to know that they can appeal if necessary!

[**LaSaJaTa** 4]

I teared up just reading your post. I could tell how excited you are, and I'm so pleased you did not give up! VSG is the best option, and you were so right to FIGHT for it! Good for you!!

[6kiddos 18]

Congratulations!

I will have all of my stuff in next week to be submitted! I am so nervous!

[Eureka-C 20]

Thank you all so much. I wish you all the best luck.

[LilMissDiva Irene 3,281]

Awesome CONGRATS TO YOU!!!!!

You are on your way now! Happy Dance!!!

:001_smile: :party4:

[M2G 1,836]

Eureka-C I sent you a PM too!

[Peffermintchili 0]

Congrats on your appeal :-) This is great news.

[Donna T 0]

So so happy for you! Dr Davidson did my sleeve too, it will be 4 weeks ago this coming Tuesday. His staff is awesome, and the Nurse practitioner there Sandy is really great and gives you her personal cell # which she answers anytime except between midnight and 5 am- and she encourages you to call with any question or problem.

On top of that, we live literally 30 minutes from each other! After your surgery is done and you can eat again we can go to lunch and split a kids meal LOL.

Congrats!

[Eureka-C 20]

So so happy for you! Dr Davidson did my sleeve too, it will be 4 weeks ago this coming Tuesday. His staff is awesome, and the Nurse practitioner there Sandy is really great and gives you her personal cell # which she answers anytime except between midnight and 5 am- and she encourages you to call with any question or problem.

On top of that, we live literally 30 minutes from each other! After your surgery is done and you can eat again we can go to lunch and split a kids meal LOL.

Congrats!

Sounds great, by the time I get my surgery, you will be a pro.

[lotusrising 0]

(Insurance is BCBS CA even though I am in Dallas)

Congratulations - that is such great news!

I'm curious - do you have Blue Shield of CA, or Blue Cross of CA? (They are two different companies in CA.) I got denied by Blue Shield of CA and my appeal was denied... but I did just a verbal/phone appeal. The letter said I can now do an IMR appeal, but I'm wondering if I may be able to write a better appeal letter and send directly to my insurance company for a "second try".

Best of luck, I have my fingers crossed to win an appeal - otherwise I will be looking at loan options.

[FitatFifty 11]

Congratulations!!! that's great news. Soon you'll be on the losers bench and watching yourself disappear!

best of luck

Fit

[Eureka-C 20]

Congratulations - that is such great news!

I'm curious - do you have Blue Shield of CA, or Blue Cross of CA? (They are two different companies in CA.) I got denied by Blue Shield of CA and my appeal was denied... but I did just a verbal/phone appeal. The letter said I can now do an IMR appeal, but I'm wondering if I may be able to write a better appeal letter and send directly to my insurance company for a "second try".

Best of luck, I have my fingers crossed to win an appeal - otherwise I will be looking at loan options.

I have blue shield CA, and I wrote my own letter. I think that was an important part of my appeal. I posted my letter on my blog, if you want to read it. others have posted their appeal letters or will email you a copy if you ask. I would go straight to the IMR appeal, but include a letter from you and from your surgeon. Don't give up.

http://eureka-thicktothin.blogspot.com/