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sleep apnea diagnosed after denial

vandernoordh

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vandernoordh    63

vandernoordh
Posted

My sleep apnea was diagnosed after I was denied the first time for not having a comorbidity. We resubmitted this past Wednesday. (crossing fingers) I am just wondering if they will count my 6 months of weight loss because now it is older than two years. Do they go back to the initial date you filed, or use the date you filed appealed as the two year mark? If nothing else in 2 months I will have another 6 months of physician monitored dieting under my belt, just hoping it will work for the initial date filled. Thanks for any input!

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Mysticpink74    50

Mysticpink74
Posted

My sleep apnea was diagnosed after I was denied the first time for not having a comorbidity. We resubmitted this past Wednesday. (crossing fingers) I am just wondering if they will count my 6 months of weight loss because now it is older than two years. Do they go back to the initial date you filed, or use the date you filed appealed as the two year mark? If nothing else in 2 months I will have another 6 months of physician monitored dieting under my belt, just hoping it will work for the initial date filled. Thanks for any input!

I'm pretty sure it's 3years? Cld be wrong but I think it's within 3 years for dieting??? Good luck & let us know!

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vandernoordh    63

vandernoordh
Posted

My insurance plan states two, but I just hope bc it's an appeal that they are able to the 6months of dieting. If it were a whole new preauth for surgery I would understand if they didn't, but it's just an appeal. Hoping it counts!

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Mysticpink74    50

Mysticpink74
Posted

But as you sd...2 more mo & you'll have that 6mo in...right?! That's what I understood anyway...

I was thoroughly disappointed when I thought my 6mo was in & found out a snag & had to put 3 extra mo in....but had my last visit on Friday....everything gets submitted this week & it flew by,,,BUT...they can't give me a surgery date soon enough!!! Lol! That's what I can't wait for! Just a date! & I'll be happy to do countdown....

but glad to know you didn't give up!! Some peeps would have by now....

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vandernoordh    63

vandernoordh
Posted

Yes, if it doesn't count 2 more months and it'll be 6 months that I've been on a supervised diet.

Good luck! Mine was submitted this past Thursday and same for me...no date till approved.

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achappex3    346

achappex3
Posted

Have you tried calling them and asking? I also have UHC and was told to call and they'll make it priority

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achappex3    346

achappex3
Posted

Yay!! Congrats!! 3 more months and I'll be right there with you!

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Marissa.Ann.C    21

Marissa.Ann.C
Posted

as sad as i am to say this it seems like they would deny because of the time frame of the supervised diet. id just wait and resubmit again after you finish the new diet in 2 months

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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