Denied for consultation appt?

[Dinks97420 52]

Has anyone had insurance deny your consultation appt with a surgeon?? My bmi is about 48 I'm 270 and only 5'1. Comorbidities had high cholesterol and I'm in last stages of finishing my sleep study with a diagnosis of sleep apnea. My insurance will cover any bariatric surgery... I'm calling the insurance rep tomorrow but very bummed ....

[anniebanana 167]

You have to be careful with this surgery because not everything involved in the workup is covered by insurance. Many of my blood tests were not covered, despite the fact that the surgery is. It's good to check with the bariatric center and find out every test they expect of you (get the codes for each procedure and test if you can), then run those by your insurance company to find out what is and what isn't paid for by them. Good luck!

[Miss Mac 6,261]

Ask your provider if they will assign you a case manager. That way, you have one contact person and one source for answers....not four different answers from four different people. Ask for a complete copy of your benefits so that you have your coverage details in writing.

The hardest part of bariatric surgery is not the operation and recovery. It is the insurance dance, pre-op diet, and pre-op testing have to do. You have to be a strong advocate for yourself. Visit us here often. No question is stupid. Somebody in this forum has been through whateveryou need support with. Opinions and tact will vary, but we mean well.

[Qwalla 132]

We have to pay about 3 thousand out of 25 thousand dollars. My doctors office found all that out after my first consult.

Sent from my SM-N910P using the BariatricPal App

[Dinks97420 52]

thank you for your help. I spoke with the insurance contact at my doctors office and they denied because the sleep apnea diagnosis wasn't in yet. She will submit again once the paperwork on apnea comes in. She did say that my insurance is one of the easiest to get approval for gastric sleeve. that was nice to hear because I dont think I'm up for a fight

[Valentina 2,642]

thank you for your help. I spoke with the insurance contact at my doctors office and they denied because the sleep apnea diagnosis wasn't in yet. She will submit again once the paperwork on apnea comes in. She did say that my insurance is one of the easiest to get approval for gastric sleeve. that was nice to hear because I dont think I'm up for a fight

Stand strong, Girl!

Sometimes I think that the ins. companies purposely "test" us to see how devoted we are in getting WLS---hoping maybe that we will give up and drop the whole thing.

IF you are determined and have done all of your research and KNOW that WLS is what you want/need then be willing to FIGHT FOR IT---FOR YOU.

You're worth fighting for. I know it from your posting. Isn't it time that YOU knew it too?

[Anania 2]

thank you for your help. I spoke with the insurance contact at my doctors office and they denied because the sleep apnea diagnosis wasn't in yet. She will submit again once the paperwork on apnea comes in. She did say that my insurance is one of the easiest to get approval for gastric sleeve. that was nice to hear because I dont think I'm up for a fight

This IS a fight, one for your life. This surgery is not for wimps, it will change how you live so you *must* be ready to fight.

The good news is you are definitely worth it.