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DENIED... AGAIN!???? (peer to peer soon)

Sandra86says

By Sandra86says, in Insurance & Financing

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Sandra86says    92

Sandra86says
Posted

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!!

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Careysgirl    20

Careysgirl
Posted

Sending prayers and hoping you get approved soon.

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careya123    260

careya123
Posted

What was their justification for the second denial? Seems ridiculous.

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kelliev2015    136

kelliev2015
Posted

Any update on this? Did you do your peer to peer?

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Stevehud    1,790

Stevehud
Posted

Good job. You CAN DO THIS!!! seriously. Its tough but you can take control of your life. and be that person you know you can be. This changes lives!

Taking the first step on this journey is the best thing you can do.

We are here for you. Ask a lot of questions. We will do our best to help.

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liposuction68    178

liposuction68
Posted

Hi Sandra Congratulations on your Approval I know you are excited !!

On February 2 i believe you came on board to tell us that you were denied for the 2nd time and that peer to peer was going to be scheduled soon. And you also asked has anyone had to have a peer to peer and how long did it take ect ect. i was excited to hear the answers since im waiting for approval. i was denied the first time. so i scroll down and Carey asked you why did you get denied 2nd time.. i again scrolled down fast because i want to hear the story . but nothing the next text from you was February 20 YOU were APPROVED. Although i am very happy for you cause it gives me a little hope about my situation that seems very similiar to yours i would still like to know what the reasons were that you got approved the first time , the second, time how soon you got the peer to peer what was said . Congratulations again did you get a date.


Hi Sandra Congratulations on your Approval I know you are excited !!

On February 2 i believe you came on board to tell us that you were denied for the 2nd time and that peer to peer was going to be scheduled soon. And you also asked has anyone had to have a peer to peer and how long did it take ect ect. i was excited to hear the answers since im waiting for approval. i was denied the first time. so i scroll down and Carey asked you why did you get denied 2nd time.. i again scrolled down fast because i want to hear the story . but nothing the next text from you was February 20 YOU were APPROVED. Although i am very happy for you cause it gives me a little hope about my situation that seems very similiar to yours i would still like to know what the reasons were that you got approved the first time , the second, time how soon you got the peer to peer what was said . Congratulations again did you get a date.

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Sandra86says    92

Sandra86says
Posted

Hi Sandra Congratulations on your Approval I know you are excited !!

On February 2 i believe you came on board to tell us that you were denied for the 2nd time and that peer to peer was going to be scheduled soon. And you also asked has anyone had to have a peer to peer and how long did it take ect ect. i was excited to hear the answers since im waiting for approval. i was denied the first time. so i scroll down and Carey asked you why did you get denied 2nd time.. i again scrolled down fast because i want to hear the story . but nothing the next text from you was February 20 YOU were APPROVED. Although i am very happy for you cause it gives me a little hope about my situation that seems very similiar to yours i would still like to know what the reasons were that you got approved the first time , the second, time how soon you got the peer to peer what was said . Congratulations again did you get a date.

Hi Sandra Congratulations on your Approval I know you are excited !!

On February 2 i believe you came on board to tell us that you were denied for the 2nd time and that peer to peer was going to be scheduled soon. And you also asked has anyone had to have a peer to peer and how long did it take ect ect. i was excited to hear the answers since im waiting for approval. i was denied the first time. so i scroll down and Carey asked you why did you get denied 2nd time.. i again scrolled down fast because i want to hear the story . but nothing the next text from you was February 20 YOU were APPROVED. Although i am very happy for you cause it gives me a little hope about my situation that seems very similiar to yours i would still like to know what the reasons were that you got approved the first time , the second, time how soon you got the peer to peer what was said . Congratulations again did you get a date.

Sorry for the late reply! Been so busy taking care of hubby, he got his gallbladder taken out Thursday so I haven't logged on!

Anywho... Ok so I got denied in July for the first time because the medical group didn't have 6 months of consecutive weigh ins, finished that in January of this year and resubmitted for the 2nd time, my medical group denied me again, they weren't happy with my PCPs notes, they weren't 'clear' enough. My PCP was nice enough to rewrite the notes for the past 6 months and I hand delivered those notes to my surgeons office and they resubmitted that same day. I found out they denied me for the 3rd time a few weeks ago and immediately called my surgeons office seeking answers. My coordinator, Alicia, bless her heart, was surprised and said she'd take care of this. I went ahead and called my medical group immediately after I called my surgeons office and the med group informed me that the medical director overturned the denial a few mins after my coordinator called! They said they made an error! Damn right they did! I clearly am overqualified (lol) and took the proper steps! Anywho, I was close to giving up after the 3rd denial but I am so glad I didn't! What a roller coaster of emotions that day was! Feel free to message me if you have any more questions! I wish you the best! I start pre op testing on St Pattys day!

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liposuction68    178

liposuction68
Posted

Hi Sandra thanks for replying I'm glad everything is going good for you. Whoohoo I know u can't wait. Ok sooo. I see it was minor things but I know it was stupid on their part insurance but thank God u stuck it out. You can do this. ....

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Go To Topic Listing Insurance & Financing

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