Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

So I got denied for the vertical sleeve from BCBS of Tenn because it's investigation. If I want to resubmit my claim for lap band or the roux en y there would still be problems since in 2007 I had lost 10% of my body weight, etc etc... I am so piss... I Will be going to Mexico.

Share this post


Link to post
Share on other sites

I went through numerous denials, and finally won, if they are denying you based on Experimental/ investigational you can definitely beat that with no problems. I Have BCBS in NY and appealed the investigational / experimental denial and won easily, call your surgeon, and primary, all three of you need to write strongly worded letters to BCBS and submit them. You should call BCBS and ask to talk to a customer service supervisor, and explain that you want the appeal handled as a expedited appeal, this way the only have one week to answer your appeal. There are people on here that have copies of their appeals letters, and links to websites with appeals letters that have worked well.

Good luck and dont give up.

Share this post


Link to post
Share on other sites

Don't give up! Have your surgeon's office write a letter, your PCP write you, and you appeal immediately by phone, etc. Good luck!

So I got denied for the vertical sleeve from BCBS of Tenn because it's investigation. If I want to resubmit my claim for lap band or the roux en y there would still be problems since in 2007 I had lost 10% of my body weight, etc etc... I am so piss... I Will be going to Mexico.

Share this post


Link to post
Share on other sites

Mine was denied at first for the same reason and my surgeon talked to them directly and got it approved.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.
    • rlcpd

      Two months out from hiatal hernia repair.  Surgeon said to expect a lot more flatulence...something about the 'air' no longer being able to 'burp' out so comes out the other end.  That is my experience but have no understanding of why that swallowed air cannot be 'burped'. ???
      · 1 reply
      1. BlondePatriotInCDA

        As I understand it since your stomach is smaller and not completely resting against your diaphragm anymore you no longer have the ability to "push" burps out as well. Plus, since its smaller and we don't digest slower the trapped air moves a lot quicker out of the stomach so its no longer available to burp out. Hence the other option for removal.

    • Lizette1122

      Anyone had the TORe procedure? How did it go? How much weight did you loose? 
      · 0 replies
      1. This update has no replies.
    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 3 replies
      1. Brookie2shoes

        Me too girl!! Are you in the full liquid diet right now? It’s sooooo hard!

      2. LadyVeteran1

        Not yet. I was told I only have to do 24 hours of a liquid diet. But I have my pre-op tomorrow so I’m going to confirm if I need to do longer.

      3. buildabetteranna

        Your so close now! It's gonna be great :) Wishing you a speedy recovery and looking forward to seeing how it goes!

    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×