Letter came i was Denied

[nancy264 50]

my first letter came in I was

Denied: The reason for this decision is that the documentation submitted by your prescriber did not contain sufficient information to determine medical necessity.

I have an appt on the 6th I will take this letter with me.

[NMJG 1,266]

Nancy, I'm sorry to hear it. Good luck on your future endeavors with this. Perhaps there is only information missing. Can you call the insurance company and ask them specifically what is missing?

[lsuchick4 54]

I was denied at first, too. I had to oh to my PCP and get a letter including his recommendation for surgery. Then the surgeon resubmitted and I got the approval.

Don't give up!

[able2cope 193]

Sorry to hear this - Please keep trying - It took me 6 years to get my surgery - it was worth the wait!

[BigGirlPanties 957]

the doctors office should also receive a copy of that letter; usually it's because additional documentation is needed by the insurance company... do not despair... it may still happen for you this year!

[Miss Mac 6,261]

One thing that was submitted with my packet was a letter I wrote myself explaining all of my co-morbidities and how they were limiting my quality of life. It sounds like what the others here are saying - that an item of information is missing. You'll get there. Just keep giving them what they want.

[nancy264 50]

im going to try and go weigh in tomorrow and ask if I can speak to Mr.Darling the Bariatric coordinator and make an appt with my nut even though she said I don't have to see her or my psych anymore I feel better if I can continue seeing them. And I see my Dr. on the 6th and I will show her the letter maybe she needs to add more information, whatever they need.

thanks ull

[nancy264 50]

went to see my dr. she wrote to my psych about the letter she said that for me not to worry that it will be approved. and she took me off the pain meds so that, since I been getting shots at the pain clinic and taking meds, she said to stop them and see how I do so im off 16 pain pills.

she wants me to start taking the Vitamins before surgery so that will be 12 added. and my reg pills which are 13 pills. so going to b taking 25 pills not 41.

I gained 4 pounds

[Rena's got this 274]

I was denied at first also. I went back to the medical clinic and had them copy all my medical records for the past 5 years. Had my surgeon's office send them in to my insurance, and was approved. I think a lot of times if you push the issue and don't just lay back and accept the denial, you will eventually be approved.

Good luck. My surgery date is Feb. 25th.

[nancy264 50]

congrats that's great. yes I went to spoke to my dr, psych, nut and the Bariatric coordinator

I was denied at first also. I went back to the medical clinic and had them copy all my medical records for the past 5 years. Had my surgeon's office send them in to my insurance, and was approved. I think a lot of times if you push the issue and don't just lay back and accept the denial, you will eventually be approved.

Good luck. My surgery date is Feb. 25th.