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Denied :(

Just got my letter from my insurance and I was denied! What do I do next? I'm crushed.

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  • ShineBright724
    ShineBright724

    Just got a call from the Bariatric Nurse and she got it approved!!!! Whoooooo! She had to call them verbally explain that I was not offered the prescription drug to surpress my hunger (which is why th

  • ShineBright724
    ShineBright724

    They told me that when people get denied the 1st time around the surgeon or Bariatric Nurse can ususally just call and verbally explain any discrepancies and then they will authorize the procedure. So

  • ShineBright724
    ShineBright724

    Well I was told that BCBS isn't too picky. I'm hoping it was lack of paperwork or something for me. Good luck!!

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Find out why you were denied. It could be something as simple as something didn't get turned into the insurance. Then you might have to file an appeal. I wish you luck!!!!!!!!!!!!1

Oh no! I am waiting for approval as we speak. My surgery date is the 15th. When i spoke to my insurance company Friday they said if I was denied a reason why would be included. I am just hoping and praying it is not denied. I will hope for you that it is something simple and you will be approved in the near future!! :)

Call them and ask why, I could just be a paper work issue. Appeal, have your surgeon and pcp give your insurance a letter of medical necessity.

You journey isn't over because you hit this bump.

  • Author

The letter said I failed to prove that I failed non surgical weight loss methods. What have I been doing for 7 months?! I listed all the failed diets I've done...

I would call back and find out if maybe you missed something or did they forget to send something...keeping u in prayers and fingers crossed :)

Don't freak!!! (Easy to say, I know). There are so many things that can go wrong with the paperwork trail, talk to your program director tomorrow and call the insurance company too. It could be as easy as someone clicking A instead of B when entering your data.

Good luck!!! Fingers crossed for you!!!!

HW 312, pre-op (RNY) 255, current weight 202.6

I too was denied a few weeks ago. I contacted my surgeon's office and asked them to help with the appeal. The had a peer to peer phone call and the insurance company reversed their decision and approved me in two weeks.

Turned out to be the doctors office failed to include all the pertinent documents.

All is good now August 21 is my surgery date....

Good Luck

Rick.

Just got my letter from my insurance and I was denied! What do I do next? I'm crushed.

I'm so sorry to hear that but everyone is right there might have been something missing! I was denied twice before getting an approval. They kept saying I had not provided adequate proof that I tried to lose the weight and then they said my BMI wasn't sufficient even though I had the lap band and it failed and my BMI was well within the numbers. After my surgeon called the head of insurance they told me that if I hit a certain level they would approve me no questions so I had to do three more months of weight loss documentation. Sometimes they play these games just to prolong it. See if your insurance has a time limit to resubmit because sometimes that is a shorter time than appealing it. Good luck!!

Just got my letter from my insurance and I was denied! What do I do next? I'm crushed.

Oh no! All of the previous posters are right-you should get on the phone tomorrow and have your dr.'s office start working on it right away. I am anxiously waiting to hear back from my insurance company...I will pray that your issue is resolved quickly and comes back approved!

For those that were denied...did anyone have BCBS? I am waiting for approval and wondering if I should be worried... Good luck with the phone calls!! Take care :)

  • Author

Thank you everyone! I'm going to call my surgeons office tomorrow and see what the next steps are. I have BCBS/Blue Care Network..

For those that were denied...did anyone have BCBS? I am waiting for approval and wondering if I should be worried... Good luck with the phone calls!! Take care :)

Ugh! I have BCBS too.

  • Author

Well I was told that BCBS isn't too picky. I'm hoping it was lack of paperwork or something for me. Good luck!!

For those that were denied...did anyone have BCBS? I am waiting for approval and wondering if I should be worried... Good luck with the phone calls!! Take care :)

I have BC/BS but after the first denial they gave me approval. I feel like they do that just to make sure you really want it.

  • Author

I have BC/BS but after the first denial they gave me approval. I feel like they do that just to make sure you really want it.

Did you have to do your nutrition appointments all over again?

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