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Denied- Should I be calling my Insurance Co?

KSTUZ

By KSTUZ, in Insurance & Financing

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KSTUZ    438

KSTUZ
Posted

So I sent my appeal letter certified last week and they received it last Friday.

Should I be calling them?

Should I be giving it more time?

I'm anxious to know if it will be appealed or not. Some people are telling me to call.

Just didn't know if anyone out there has had any idea about being denied and appealing.

Thanks! :)

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notsuccessfulyet    0

notsuccessfulyet
Posted

What was the reason for denial? When I was denied, I called everyday and had the representative quote to me what my benefit read. Sometimes it can take up to 30 days for an answer I was told. Be persisent and you will win. Just make sure each appeal is well documented and have your doctor appeal on your behalf.

It took me 3 times before I was approved. They are hoping you give up.

Good luck

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Dragonfly1111    61

Dragonfly1111
Posted

Hi! Yes. I was denied. I sent a letter asking for my insurance to re-evaluate my case. I gave them my medical history and explained why I thought I was a good candidate for the surgery. I did call and follow up. Didn't want to get lost in the shuffle. So to speak. My doctors office told me that 50% of their patients who appealed to their ins. ended up getting approved. It worked for me! Good luck! I think most insurance companies just deny and hope the patients don't put up a fight.

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KSTUZ    438

KSTUZ
Posted

Thank you for your responses.

I'm calling in 5 min!!

My surgeons office already sent a letter of appeal and I mailed my 4 page appeal last week.

I just didn't know if I should be calling them everyday or what to even say.

Thanks for the tips! Keep ya's posted!

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KSTUZ    438

KSTUZ
Posted

Ok well I called and they said they will be making a decision by August 16th.

So here's to hoping for approval!!

tnl1031 and Beth Pets reacted to this

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woo woo    872

woo woo
Posted

Yes, you can call them anytime you feel like it to see if anything has been updated on your file.

I actually was able to find out that my appeal went through and was approved like 3 weeks before they got around to sending out a letter.

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tnl1031    52

tnl1031
Posted

Any word yet?

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KSTUZ    438

KSTUZ
Posted

<p>Any word yet?</p>

I just got off the phone, they denied my appeal :(

I'm speechless. And really sad.

Thanks for thinking of me :(

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kelew39    64

kelew39
Posted

I just got off the phone, they denied my appeal :(

I'm speechless. And really sad.

Thanks for thinking of me :(

Oh man, I'm so sorry. I hope this isn't a setback for you. Can you start the appointments over? Start fresh from 3 months?

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Darla15    21

Darla15
Posted

NO!!!! =( I am so sad for you!!! WTH is wrong with these insurance companies!?!?

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Jersrose43    837

Jersrose43
Posted

You need to ask for a peer to peer review. And I believe you were denied for gaining weight pre op? But was medication related? So have the doc who have you medication write them in regards to side wffect of the drugs.

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KSTUZ    438

KSTUZ
Posted

I just got off the phone, they denied my appeal :(

I'm speechless. And really sad.

Thanks for thinking of me :(

Oh man, I'm so sorry. I hope this isn't a setback for you. Can you start the appointments over? Start fresh from 3 months?

Yeah I have my 2nd month nut app next week

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KSTUZ    438

KSTUZ
Posted

You need to ask for a peer to peer review. And I believe you were denied for gaining weight pre op? But was medication related? So have the doc who have you medication write them in regards to side wffect of the drugs.

Yeah because of depression meds and I was taking care of my husband after his heart attack and triple heart bypass at age 37. I even gave them all his discharge sheets so they didn't think I was just making up a story (even tho I dunno who would do that but ya know)

I have to pick my letter up from my doctor pcp tomorrow and call the surgeons office to see what to do next. 2nd appeal but I'm still going for another 3 months appts. Next week will be my semiconductor month nut visit

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Krystal0528    118

Krystal0528
Posted

What insurance company is this that is sending you through the hoops? I wish that these insurance companies would stop doing this to people an get on board. You'd think they would want to pay for it, because if we don't get it and continue gaining weight then more an more medical problems would occur! Ugh.. I'm so sorry you are going through this, an I hope your next appeal goes well. I'm so glad my insurance company didn't do this to me, I would have lost it on them! Lol.. I will keep my fingers crossed for you. I promise;)

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Dragonfly1111    61

Dragonfly1111
Posted

I just got off the phone, they denied my appeal :( I'm speechless. And really sad. Thanks for thinking of me :(

I am so sorry to hear this. I would def appeal again. Keeping you in my thoughts. :)

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Go To Topic Listing Insurance & Financing

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