What? Denied? Why?

[paigelarson89 19]

As of now I don't know why I was denied. Insurance on said not medically necessary. I will talk with my dr. Tommarow. For peets sake my BMI is 42. I did three months of weight checks via 90 days. I have HBP, acid reflux. Wishing for that rainbow!

I was denied the first time my doctor sent in more information and my mom, physical therapist, doctor, and I wrote a letter to the insurance company and the clinic then sent everything in and was approved the second time. Don't give up. Appeal tell they approve you fight for your future, and your life.

[MthrEffinPrncss1126 11]

As of now I don't know why I was denied. Insurance on said not medically necessary. I will talk with my dr. Tommarow. For peets sake my BMI is 42. I did three months of weight checks via 90 days. I have HBP, acid reflux. Wishing for that rainbow!

I was denied the first time my doctor sent in more information and my mom, physical therapist, doctor, and I wrote a letter to the insurance company and the clinic then sent everything in and was approved the second time. Don't give up. Appeal tell they approve you fight for your future, and your life.

I actually work for a health insurance company and I see all too often people that need the work done and procedure are being denied as "not medically necessary". I just want everyone to know, you all have the right for a 1st level appeal and a 2nd level appeal and peer to peer. These are just some things that will help to get your surgery approved.

[paigelarson89 19]

I actually work for a health insurance company and I see all too often people that need the work done and procedure are being denied as "not medically necessary". I just want everyone to know, you all have the right for a 1st level appeal and a 2nd level appeal and peer to peer. These are just some things that will help to get your surgery approved.

I had my surgery September 16, 2013. So I agree appealing does help.

[Luckyinluv 30]

Update: insurance wants a letter of medical clearance from dr. So I got that faxed to them and they said it could be another two weeks before I hear anything!! Over one paper?? My surgeons office said they would call me as soon as they heard!! If all they wanted was medical clearance wouldn't it be approved? And not take 2 full weeks?

[jtickle 295]

I called my insurance company everyday, sometimes once in the morning and then once close to closing time to check the status of my case. No one ever told me not to call. Actually one of the reps told me to call as much as I wanted to.

[paigelarson89 19]

I called my insurance company everyday, sometimes once in the morning and then once close to closing time to check the status of my case. No one ever told me not to call. Actually one of the reps told me to call as much as I wanted to.

Same here I called every week though, and it helped

[happymomandwife71 2]

Hang in there. It will workout.

[MthrEffinPrncss1126 11]

Update: insurance wants a letter of medical clearance from dr. So I got that faxed to them and they said it could be another two weeks before I hear anything!! Over one paper?? My surgeons office said they would call me as soon as they heard!! If all they wanted was medical clearance wouldn't it be approved? And not take 2 full weeks?

The company that I work for states that it could take up to 6 weeks for approval. I know that it is manually scanned into the system and manually reviewed by he medical review department. But...cross your fingers because I've seen them approved in a few days!!! Good Luck!!

[Luckyinluv 30]

Finally got Approval from insurance!! So excited!! My Lord heard my prayers!! Most likely a late June surgery!

[Ginger Snaps 1,323]

So happy for you!!! I've been watching this thread hoping to see this post!

YAY!

[Luckyinluv 30]

<p>So happy for you!!! I've been watching this thread hoping to see this post!</p>

<p> </p>

<p>YAY!<br>

</p>

Thanks bunches!! So ready and excited!!!

[jodie1961 77]

Luckyinluv, so happy for you. It is like a weight lifted off of you just to get the insurance approval! It can happen so fast now. I finally got my approval on a Monday, went for labs on Tuesday, Friday the office called and scheduled to see surgeon on the next Friday (May 2nd)..saw him, they scheduled me for May 13th! On my 4th day of pre-op diet, and and only 4 more days of diet before Surgery day! Here's to a surgery date in the near future for you!

[Luckyinluv 30]

Yes I have had very stressful days and I feel so much better. Good lick with ur surgery and ass keep posting. We want to hear the good, bad and ugly!! Heehee

[Skinnyana 35]

I'm on Medicaid ,does anyone know if its hard to get approved through them?

I have amerigroup healthplus under medicaid and i was approved in two days. Go for it medicaid will aprove it!

[STARTING NEW 21]

Hello,

I am in the process of started my visits and i am wanting to know what is deemed medically necesssary per title 19? I called the customer care and I was informed only my provider can request that information? If anyone can help me I would appreciate it??