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

Recommended Posts

I have done my 6 month supervised weight loss and my DR submitted it to my insurance company. I have got a letter in the mail saying it was denied because it was pre existing and I have to have had the insurance a year. The year is on May 1st.

So my question is....

Can I resubmit next month?

Do I need to still go to my monthly Dr appointments?

Has this ever happened to anyone?

Share this post


Link to post
Share on other sites

Your surgical coordinator should handle things like this for you.

Share this post


Link to post
Share on other sites

I am impatient. I got the letter yesterday/saturday and she isnt in the office.

Just curious if anybody has had this happen

Share this post


Link to post
Share on other sites

Talk to your patient advocate/insurance person in your Dr.s' office.

Share this post


Link to post
Share on other sites

Awww...I'm sorry that this happened. I hope your doctor's office gets it straightened out so you'll be approved. Good luck!

Share this post


Link to post
Share on other sites

I'm sorry that that happened to you! Impatience is hard in this process. Wait to talk to the bariatric surgery coordinator tomorrow. They will be able to help you and tell you your next steps! You'll get there!

Share this post


Link to post
Share on other sites

That really bites! I can only imagine how disappointed you are. The good news is this - your dr's office is highly motivated to get you approved. A doctor may be the most caring, giving person in the world but the motivating factor is still money. They like to make money especially with the inflated prices they charge to insurance companies. Hang in there! I'd be willing to bet they find a way to get you approved.

Share this post


Link to post
Share on other sites

I am impatient. I got the letter yesterday/saturday and she isnt in the office.

Just curious if anybody has had this happen

Hi Lala.. Sorry to hear about the denial.. But out of curiosity which insurance company are you with? I just started a new insurance.. And haven't been with them for a year.

Share this post


Link to post
Share on other sites

Resubmit after May 1st. Since you're in your pre-x period, they probably didn't review your file at all.

Keep doing what you were doing and tell the surgeon to resubmit May 1st

Share this post


Link to post
Share on other sites

Hi Lala.. Sorry to hear about the denial.. But out of curiosity which insurance company are you with? I just started a new insurance.. And haven't been with them for a year.

You can call your insurance and ask if you have a pre-existing waiting period. They can tell you when it ends (can be up to 2 years)

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

    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.
  • 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

    ×