Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Insurance approval question



Recommended Posts

Ugh. Another set back..letter from insurance today states my approval is "pending" because they do not have md notes, diagnostic testing, methods and dates of documented weight loss attempts. Per my surgeon, I was required to do the 6 month md monitored weight loss attempt. So I did the 6 months of classes, had the psych and dietitian clearances. What else do they need?? Or did my surgeons office not submit it all?? I'm calling tomorrow and hopefully they have received this letter as well and already fixed the issue.

Share this post


Link to post
Share on other sites

Ok. So per Anthem they definitely do not have my clinicals. Called my surgeons office and the insurance gal is out until Monday and no one else can refax my documents. I asked and was told "we aren't going to go into her office rifling around in her paperwork...". Wow. Ok.... I'm very frustrated right now. This insurance gal has been full of excuses and explanations why things have been delayed. This Friday will be 3 weeks since my last surgeon consult and nothing has been received yet. First it was she wasn't sure which procedure I had decided on (even though it was in the dictation). Oh the sleeve? Ok, I will send it right over. (This was my first inquiry as to why my stuff hadn't been sent). Second time I was told that the Availity online submission program wasn't accepting my documentation for "some reason". So she had to fax the stuff and she said she did that last Friday. Got my pending letter from Anthem stating no supporting documentation. They have not received a fax. Called the office today, she's out, no one else can do it but the office manager said " she sent everything thru Availity". Uh no...ran thru the whole sequence of events and she didn't know what to say. So more waiting for me. I know ppl say the insurance companies are the hard part but my reps have been very helpful and encouraging. Sorry this post is so long- I just really needed to vent.

Share this post


Link to post
Share on other sites

I'm having the same problem with BCBS/anthem. My appeal was sent in 9/8. Program coordinator said it took 30 days. Been calling every week. called the number on the denial letter.no one knows anything. Today, after being being on hold for 1 hr I was finally told she's not in. there's an hour of my life I'll never get back! ugh. so, I don't know anything more today than I did on 9/8. Thanks so much BCBS.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 0 replies
      1. This update has no replies.
    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×