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Denied The First Time?



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Has anyone besides me been denied the first time then was approved the second time by the surgeon? My insurance covers it.

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I have not submitted to the insurance yet. But, many others have posted on here about their denial experience. You can have your Surgeon or pcp write a letter of medical necessity. You could ask your Surgeon's office to arrange a peer-to-peer review.

Make sure it's documented that you meet the requirement.

Keep trying. Don't give up.

Good luck!

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My thing is the first time I had my meeting with the surgeon he said basically I didn't qualify I had the bmi of 39 and it needed to 40 or greater. Well now I'm going back to see him I'm at my normal weight which is 242-245 I was 215 at the time an I'm 5'2. I was going through a divorce and I did not eat so I was basically starving my self when I loss 34 pounds.

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You have to stay on top of this. Don't give up. After you see your Surgeon then find out from maybe the office coordinator or who is in charge of your case what else is needy. and be pro active for your self. We are here for support.

Keep us posted.

Good luck.

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You are not alone.

My weight is 264 and I have concerns too. i have no approved co morbidities. But I will work hard follow the program ect. So I can Rock my sleeve soon!

Keep you head up girl.

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Here at the hospital in ga the surgeon says bmi 35 with comorbidities and 40 and above automatically approved. So I'm hoping this time I can get approved with the bmi of 43 almost 44

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I've been denied & currently in appeal. :/ coordinator submitted with missing info... Ugh

++++++++++++++++++++++++++++++++ 347*294/284/135 (*347HW/294SSW) | (twitter) @Mwrarr | mwrarr.wordpress.com

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I was denied the first time by the actual surgeon my bmi was 39 and I didn't have any problems. My bmi now is 44 and I have been having pcos.

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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