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Re-submission after denial

I found out my insurance denied the preauthorization about a month ago. I have been tracking down notes from every doctor I have seen for the past 10+ years and finally delivered it all to my surgeon's office this afternoon. The scheduler faxed 98 pages to my insurance company...now to wait for some good news! Please, if you are so inclined, say a little prayer for me. I am so ready to do this.

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  • I was denied and then denied again with my appeal and then the surgeon scheduled something called a "peer-to-peer" review. That seemed to do the trick. Apparently, this peer-to-peer review is my

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Sending prayers your way

I found out my insurance denied the preauthorization about a month ago. I have been tracking down notes from every doctor I have seen for the past 10+ years and finally delivered it all to my surgeon's office this afternoon. The scheduler faxed 98 pages to my insurance company...now to wait for some good news! Please' date=' if you are so inclined, say a little prayer for me. I am so ready to do this.[/quote']

Prayers and good thoughts coming your way. Good luck !!

Keeping you in my prayers. Hope you get good news.

Many prayers for a positive response.

Praying! :)

I was denied and then denied again with my appeal and then the surgeon scheduled something called a "peer-to-peer" review. That seemed to do the trick.

Apparently, this peer-to-peer review is my doctor scheduling a phone call with an actual doctor from the insurance and my doctor explaining all the problems using medical terminology, I was having with my lap-band and that I now have a hernia, which could cause bigger issues. It worked and I was approved.

It wasn't a quick process by any means, but it worked. Between each of the appeals and the doctor review the insurance has 30-days to respond.(Response time could be different based on ins. company rules.) My whole process was 8-mths long, but I started with one doctors office and changed due to his horrendous staff and poor bed-side manner, so the process started over.

Good luck!!! I am having surgery 09/16th and I am soooooo excited.

  • 4 weeks later...
  • Author
I found out my insurance denied the preauthorization about a month ago. I have been tracking down notes from every doctor I have seen for the past 10+ years and finally delivered it all to my surgeon's office this afternoon. The scheduler faxed 98 pages to my insurance company...now to wait for some good news! Please' date=' if you are so inclined, say a little prayer for me. I am so ready to do this.[/quote']

I haven't been on the board lately, school started back up and I am in my last semester of grad school. My surgeon's office did not submit in early September like I had been told....I finally got mad enough to call my surgeons office as well as the hospital bariatric nurse navigator to get the scheduler (probably 80 year old woman) to send everything I gave her weeks earlier. I confirmed yesterday that my insurance company has everything and they said it is all under review. Here's to hoping (AGAIN) for an approval...I am past ready for this...

  • 2 weeks later...
  • Author

Called BCBS and found out that I have been denied a 2nd time. It is strange because I followed the insurance company's written requirements. I qualify based on my BMI alone, but also have co-morbidities. Now I have to wait for the written denial so that my surgeon can schedule a peer to peer review. I can't help but to feel incredibly discouraged...

Called BCBS and found out that I have been denied a 2nd time. It is strange because I followed the insurance company's written requirements. I qualify based on my BMI alone' date=' but also have co-morbidities. Now I have to wait for the written denial so that my surgeon can schedule a peer to peer review. I can't help but to feel incredibly discouraged...[/quote']

Did BCBS say why it was denied?

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