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Seriously Disappointed!

My doctor's insurance coordinator emailed me and said it will be another two weeks until we hear from the insurance company. She had to appeal due to my BMI for the past three years being from 38 to 41. All you experienced sleevers, is this the point where I start calling my insurance company everyday? I have documentation for 7 years worth of failed dieting efforts with none of the comorbidities they consider, however, I do have degenerative disc disease and bulging discs as well as planters fasciitis, fibromyalgia and chronic fatigue. Has anyone else been approved with these types of issues on an appeal? I guess I just need an encouraging word right now!

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  • HalfTheWoman
    HalfTheWoman

    My insurance turned me down initially...so I called them and didn't just talk to the lady on the phone who was "suppose" to be helping me. She told me it got turned down by a nurse. I asked to speak

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My insurance turned me down initially...so I called them and didn't just talk to the lady on the phone who was "suppose" to be helping me. She told me it got turned down by a nurse. I asked to speak to that nurse directly and explained my situation. She told me that just 10 minutes before my doctor has called and spoke to the doctor in charge of making the decision. 3 days later I was approved. I am very thankful to my doctor but most of all to God for my surgery. I have come a long way...I still have a long way to go but I am getting there. I think you should take charge of your life...starting with your insurance company!

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Thank you so much, I needed to hear that!

Yes, thank you! Just got the call today I am denied for the same reason. How crazy is this - if I just weighed 15 more pounds during the last 5 years, I'd be covered! Damn me for not eating that 4th piece of cake! ha ha!

Called the dr, waiting for chart notes to be sent over, showing that I had a high fasting blood sugar (let's hope it's high enough!) and high blood pressure at some point. I really hope the WLS dr. can help me out. They told me today they take care of the appeal, I don't have to. *fingers crossed!*

I got denied because the nurses rarely weighed me. I have been overweight for years but every trip to the drs office, they took my temperature and vitals but not my weight. My insurance requires documentation of a certain BMI. We are now doing a peer to peer and if that doesn't work we have to appeal. Ugh.....so frustrating!!!

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