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Beyond Sad Request Deneied

I just came from the mailbox retrieving 4 letters from my insurance provider. After getting all of my clearances completed some how I still got denied. I am sitting here in tears, and frustrated as well as exhausted with this entire process.

The letter says reason(s):

Inadequate or no clinical data received to complete review. I have no more words and am feeling like maybe this is just my life and I should except it. Going to bury my head under a pillow now. #sotiredoffighting

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  • Author

Thank you so much for that reminder because I may have forgotten to do just that. I will definitely make sure I ask who it is that I am speaking with and document the conversation. I am feeling much better now so I going to get into the ring and come out a victorious winner. Thanks again.

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  • Author

Hi Kaitlyn yes it was very confusing to read through. The surgeon that I have chosen is definitely at a designated Blue Distinction Center. This center is in fact the only one near where I live. I'm praying that after speaking the surgeon's office this will be resolved soon. Thanks so much for your insight.

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@@DivaSoBlessed

I will be crossing my fingers that your insurance will reconsider. No one should be denied a fighting chance to obtain a healthy life. Sometimes they just need to be reminded that we are so much more than a case file number.

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  • Author

Your welcome if you meeting doesn't work let me know and I will try to send you a copy of my appeal letter that was used to get me approved.

Thank you so much. That is very kind of you to offer. I will keep you posted and let you know what happens and reach out to you for a copy if things don't go as expected. I am hoping that the get every thing that they need this time to make a decision. ????
  • Author

@@DivaSoBlessed

I will be crossing my fingers that your insurance will reconsider. No one should be denied a fighting chance to obtain a healthy life. Sometimes they just need to be reminded that we are so much more than a case file number.

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Thank you so much! I will take all of the help and blessings that I can get. I am praying that they get everything that is needed this time to make their final decision. You are definitely right we all should have a fighting chance at a healthy life especially when we've committed to making the necessary changes towards changing out of old habits and situations that put us in a unhealthy state to begin with. We are definitely more than just a case file number and I get that when you come across many files daily how hard it is to keep in mind that we are individuals reaching out for help. I will keep everyone posted on the outcome. Thank you again! ????

I couldn't go through insurance so opted for self pay. My credit isn't the greatest so I couldn't get financing either. I've been dreaming of this for 18 months and finally this week was able to book my surgery and flights for Tijuana. I'm having my surgery through " long term vsg ". They have a a promotion on until may for $2999 all inclusive.

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  • Author

I couldn't go through insurance so opted for self pay. My credit isn't the greatest so I couldn't get financing either. I've been dreaming of this for 18 months and finally this week was able to book my surgery and flights for Tijuana. I'm having my surgery through " long term vsg ". They have a a promotion on until may for $2999 all inclusive.

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Thank you so much for this information Bohemian! Congratulations! I am estatic for you taking matters into your own hands and moving forward with your plans to live a healthier life. I will keep this in mind as a last resort. ????

All the best to you! Sounds like you're just a couple steps away from having that long awaited surgery date scheduled! :-)

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I really must say I am liking this group more each day and amazed by how you've all come together to support Diva and encourage her not to give up on her quest for WLS. As they say anything worth having is worth fighting for and this is one of those things. I pray that everything works out.

I got the same letter BUT I decided that if my Bariatric team hasn't said anything to me then imma keep pushing through. I'm scheduled for surgery March 17 pre admitting March 15. I'm going on as if I DID NOT receive a letter. I feel if there is an issue with my insurance their billing department will contact me like they contact me for co pay and program fees. I think your good. Your team will handle it.

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  • Author

Thank you @@crazygoose and @@Tan4sho! This group hands down is the best and I am grateful for each and every one of you who have rallied around me to show your support. This journey for each of us has its ups and downs. I understand that right now I am in the down stage but I know that I won't stay there. This has indeed been a very long journey and I can't give up. It is my last hope at getting my body healthy and having at least one child before I am too up in age to have one. I had a dream where I pictured myself healthy and l saw myself as the skinny woman that I use to be holding a baby. I want that dream to become my reality more than ever. It is all that I think about constantly. I'll be 40 next month and I know that the clock is ticking so I refuse to throw in the towel and give up without a fight. I've wasted too much time being passive as it is. I now know that I am not the only one who has received this kind of letter and I am more than confidant that my surgical team will get this all sorted out. Our group us full of ROCKSTARS and again I thank each and every one of you! @@Tan4sho congratulations on your upcoming surgery. I am rooting for you all the way. @@crazygoose the same goes for you as well. I am rooting for you all the way! I'll see you when we make it to the losers bench! :)

  • Author

@@NavarreMom Thank you so much! I am praying for it to happen soon. It would be an awesome birthday present. I'm going to work closely with my surgical team so that we can get the ball rolling. I can't wait to make it to the losers bench. :)

Hey just reading your post and I think you said on one of the letters it said blue distinction center well that's apart of my policy as well not all centers are there are usually a select few in your state that are I actually had to switch programs because of that. Google blue distinction centers in your state and if your hospital isn't listed then you need too go to one that is

  • Author

Hey just reading your post and I think you said on one of the letters it said blue distinction center well that's apart of my policy as well not all centers are there are usually a select few in your state that are I actually had to switch programs because of that. Google blue distinction centers in your state and if your hospital isn't listed then you need too go to one that is

Thank you so much Jessica. The place where I am trying to have the surgery approved is actually a Blue Distinction Center. It is the reason that I chose it and is the only one closest to where I live. Hopefully I can have all of this straightened out with these letters next week. Thanks again for the tip. ????

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