Scared of being denied....

[blue8eyes 9]

Hello everyone!! I just recently started my journey for weight loss surgery and can say I'm super excited!! However I have this fear of being denied my surgeon gave me a surgery date of December 16 and I have been going to a ton of appointments just nervous because I have a surgery date without an approval. Anyone else experience this? It's very emotional for me. I have Empire BCBS metropolitan plan and my bmi is 44 they told me I have great insurance and they don't feel there's any concern for denial but after reading a lot of post I'm nervous

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[busybeebug 415]

If you followed and hit the benchmarks your health insurance obesity medical policy requirements and it's a covered benefit, you should have no problems. Even if they find something to nit pick about, your surgeon can do a peer to peer review, if that fails, you and the doctor can appeal. You do have time to fight with the worst case scenario.

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[WLSResources/ClothingExch 3,443]

"Scared?" "Fear?" I don't want to spoil your fun, but wouldn't simply "wondering" be easier? Even worse, maybe, just maybe, the people at your surgery practice know something? Maybe, when they tell you that they see no problem with coverage, there will be no problem?

If I were starting anew, I'd be chirping about all the positive prospects and leaving the doom and gloom behind.

[blue8eyes 9]

It's true! Just planning my whole life around this and doing all this work just gives me a bit of anxiety

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Edited September 18, 2016 by blue8eyes

[blue8eyes 9]

Also there telling me I don't need to do 6 month medically supervised diet and from what I've read in a lot of post you do

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[WLSResources/ClothingExch 3,443]

planning my whole life around this and doing all this work

So-o-o, you've stopped brushing your teeth and going to work or school? All what work? A few phone calls, a couple of appointments? I know: Anxiety ain't no romp in a meadow.

Also there telling me I don't need to do 6 month medically supervised diet

That sounds as though your medical plan doesn't require it. Read through your plan literature and verify with the practice's insurance coordinator.

Your assignment for the evening is to do something that makes you giggly.

[blue8eyes 9]

Sounds like a plan will do!????

[Jen-2+1 131]

My surgery is in a week and I haven't been approved yet. At my surgeon's office they schedule your surgery date the same day your paperwork is sent to the insurance company, so nobody knows that they are approved until after they have their date.

[HuneComz 103]

This is a big worry for me, too. In my first contact with my surgeon's office I advised them that my insurance's website states they don't cover it unless pre-approved and that a coworker who needs the surgery much more than I do claims he was denied. My surgeon and his staff advised that they called and confirmed my insurance covers it, I have the insurance requirements to follow (only a 3 month physician/dietician supervised diet), I have taken all my tests, done all my blood work, etc. The surgeon stated that if you follow the insurance's requirements, they can't deny it. They either cover it or they don't.

A month or two into the process, I had to self-pay for the sleep apnea test and I simultaneously received a notification from my insurance about a portion of the bloodwork not being covered. I contacted my surgeon's office again and said I am not in the position to pay out for these things if I will be denied in the end. I still had to self-pay for the sleep apnea test but they straightened out the rest and I have only paid my normal co-pays otherwise, but I am still worried. It took me a long time to decide I can't lose the weight all on my own and I will be very disappointed if my insurance denies me once I am to that point (which I anticipate being next month).

I think we just have to have faith and trust in our surgeons. Good luck to you.

[blue8eyes 9]

Thank you so much for your response your right faith is the key thing I hope it all works out for us!!

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Edited September 19, 2016 by blue8eyes

[KristenLe 5,979]

@@blue8eyes Don't worry about other's requirements that you read on the forum! There are many different insurances, different plans within that insurance, etc. Your surgeon's office are experts at this and you should feel confident that there will be no issues. Many BCBS plans have removed the 6 month supervised diet requirement. I didn't have one due to my BMI (only time being super fat helped me! lol). Stay positive!!!

[blue8eyes 9]

Lol!! Thank you!!

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[The Candidate 3,215]

I was the same way. In fact I kept coming up with new and unique reasons in my head that I could be denied. I pretty much drove myself crazy.

But then it came, the approval notification and I was in seventh heaven... for maybe 15 minutes. And then I started worrying about not getting a surgery date.

Worrying is part of the process, but try to focus on how great your life is going to be afterwards. That's much more fun!

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[blue8eyes 9]

lol it's true I do the same thing! And yes your right I can't wait my surgery!

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[Iisa8181 6]

I too had the same fear. Once it got submitted I kept preparing myself for denial and h ow to fight it lol. I was so excited upon aproval. Dont stress and just tak t one step at a time. Good luck!