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BCBS of AZ denied!

Janett

By Janett, in Insurance & Financing

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Janett    87

Janett
Posted

After a long journey :( all my documents were sent for approval, 5 days later I got denied. My surgeon's office will send an appeal letter on Monday hopefully I get approved :)

Any suggestions?

Should I call BCBS my self?

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NewAshes    232

NewAshes
Posted

You should find out why you were denied

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AmandaRaeLeo    2,146

AmandaRaeLeo
Posted

I went to Dr. Aceves in Mexicali, Mx as a self pay.

Amanda Rae

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Janett    87

Janett
Posted

According to BCBS, I havent had a co-morbid condition for the past 5 yrs (which I have) thats why it doesn't make sense :(

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NewAshes    232

NewAshes
Posted

You should talk to your doctor or surgeon make sure they did the paper work correct.

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jd1988    10

jd1988
Posted

I would defiantly call your insurance to find out if the doctor sent in ALL of your paperwork....my doctors office forgot to send in my psych evaluation and didn't even list my co morbidity... So that is the reason I got denied within two days... I called both everyday!!! Don't assume they sent in everything... I appealed it and finally was approved yesterday... Stay on it... Hope this helps :)

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Janett    87

Janett
Posted

I will call both places.. My surgeon's office should be sending the appeal letter on Monday ...Hopefully it gets approve :) if not, we're going to do a peer to peer etc etc :( I was so exited and ready! Now its waiting time again :( thanks!

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jd1988    10

jd1988
Posted

Yeah my doctor did that and he kept canceling and rescheduling... It's really frustrating.... After I thought I was done with all my stuff the doctor kept saying you got to do this in that... Do you have a surgery date ??? I had one before I was even approved..

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Janett    87

Janett
Posted

No surgery date yet :( they wont give you a date until your approved ...

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jd1988    10

jd1988
Posted

I think they approved me because I made sure I let them know that my medications cost a lot so they would actually save by having the surgery... So if you have a co morbid condition try in use everything you can hopefully your doctor just forgot to include something... Something that can just be re sent in or whatever... I was scared because my supervised diets I had to do my doctor didn't document enough so my surgeon said they will pretty much deny you for that... I was so disappointed.... Just keep trying and if they deny appeal it again and again..

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jd1988    10

jd1988
Posted

I think you can always appeal so if you get denied you can appeal so I don't think there is a limit

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

      Alisa_S

      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.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Alisa_S

      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.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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