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????Denied... AGAIN! (Peer to Peer review)



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So I started this process about a year ago. Got denied in July because I didn't have my 6 month Supervised diet. Completed the 6 month last month. Submitted on 1/20 and got denied again... My coordinator will set up a Peer to Peer Review w the Surgeon and my insurance company (Blue Shield of Ca) to put an end to this madness. My question to those who ended up having a peer to peer : 1) About how long did it take to get an approval / denial? 2) How was the experience? I am so overwhelmed and frustrated at this point. I currently have 2 comorbidities and my BMI is 50! I see many people get approved so easily with a BMI way less than me and No comorbidities! I need many prayers!!

Edited by Sandra86says

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Oh my!!! I have no experience with this, but just wanted to say that your situation stinks!! It seems obvious that this would be a great choice for you! Hope it all works out and quickly for you!

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why did they deny it the 2nd time. I have blue shield of ca, and I did the 6 months, bmi 48, with htn and arthritis, and high cholesterol, and I was approved right away. I also heard that now they only require a 3 month supervison. Good luck, hope it goes through next time. Hope doc office is doing it right on the request.


why did they deny it the 2nd time. I have blue shield of ca, and I did the 6 months, bmi 48, with htn and arthritis, and high cholesterol, and I was approved right away. I also heard that now they only require a 3 month supervison. Good luck, hope it goes through next time. Hope doc office is doing it right on the request.


why did they deny it the 2nd time. I have blue shield of ca, and I did the 6 months, bmi 48, with htn and arthritis, and high cholesterol, and I was approved right away. I also heard that now they only require a 3 month supervision. Good luck, hope it goes through next time. Hope doc office is doing it right on the request.


why did they deny it the 2nd time. I have blue shield of ca, and I did the 6 months, bmi 48, with htn and arthritis, and high cholesterol, and I was approved right away. I also heard that now they only require a 3 month supervision. Good luck, hope it goes through next time. Hope doc office is doing it right on the request.


why did they deny it the 2nd time. I have blue shield of ca, and I did the 6 months, bmi 48, with htn and arthritis, and high cholesterol, and I was approved right away. I also heard that now they only require a 3 month supervision. Good luck, hope it goes through next time. Hope doc office is doing it right on the request.


why did they deny it the 2nd time. I have blue shield of ca, and I did the 6 months, bmi 48, with htn and arthritis, and high cholesterol, and I was approved right away. I also heard that now they only require a 3 month supervision. Good luck, hope it goes through next time. Hope doc office is doing it right on the request.


why did they deny it the 2nd time. I have blue shield of ca, and I did the 6 months, bmi 48, with htn and arthritis, and high cholesterol, and I was approved right away. I also heard that now they only require a 3 month supervision. Good luck, hope it goes through next time. Hope doc office is doing it right on the request.


why did they deny it the 2nd time. I have blue shield of ca, and I did the 6 months, bmi 48, with htn and arthritis, and high cholesterol, and I was approved right away. I also heard that now they only require a 3 month supervision. Good luck, hope it goes through next time. Hope doc office is doing it right on the request.

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I heard blue shield is a rough insurance company to get approval through unless you have medical necessity. I started the process a year ago and then my Doctor, she's a whack, backed out a few months in. I switched doctors and had the surgery 6 months later! If is meant to be, it will be. Just make sure you're giving it your all.

Edited by kristennichole

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I was denied twice because our plan didn't offer the gastric sleeve, just the bypass, and lapband (?!?) lapband? It time our benefits committee updates the policy!! I went t self-fund. I'm sorry it's been so difficult journey for you.

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What tier on the plan do you have? Did you get approved for the initial visit with the surgeon?

Edited by lupelane

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