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Peer to Peer...waiting

I'm new on here, but I've been following religiously. I've gotten a lot of great information from you all!

The frustration is REAL! I'm 48, my BMI is 35.2. I have HBP. high cholesterol. GERD. and degenerative disc disease with scoliosis.

My insurance (MVP) (I'm in NY) covers bariatric surgery. The insurance denied me because they said my BP was controlled on Sept 9,2016, and so was my cholesterol. For a year straight, my primary doctor has written that my BP is poorly controlled. I went back to her again a week ago, and she wrote me a letter of medical necessity.(not sure why they didn't ask for this before they submitted my paperwork) My BP was again high, so she added a second BP med. How is this controlled?

I'm waiting for my surgeon to do a peer to peer. They keep playing phone tag. I've been patiently waiting for over a week for them to speak. My surgery is scheduled for Nov.14th. I wish they wouldn't do that, because this is stressful enough!

Any thoughts on the peer to peer outcome?? Thanks

Kelly

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  • QueenOfTheTamazons
    QueenOfTheTamazons

    Peer to peers can be helpful. The furst p2p my surgeon did helped us find out specifically why the ins was denying me. They were saying that i hadnt cometed the 6 months medically supervised diet, whi

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Peer to peers can be helpful. The furst p2p my surgeon did helped us find out specifically why the ins was denying me. They were saying that i hadnt cometed the 6 months medically supervised diet, which i had. During the P2P, we found out that the lack of notes in my chart regarding exercise as part of my diet plan was what they were denying me for.

The second one was the push needed to get approved (once i provided the info needed from the first denial).

HW 385 SW 359 CW 344 Sleeved 10/5/16

  • Author

Thank you Queenofthetamazons for the quick response. I think the waiting and worrying is the worst. I guess no news is good news!

Trust me. I get it.it took me 3+ months to get approved and now we are playing the waiting game with my husband.

HW 385 SW 359 CW 344 Sleeved 10/5/16

  • Author

Sending positive vibes for your hubby!

  • Author

It's been a total of 4 weeks, and my dtr still hasn't done my peer to peer, and my surgery is scheduled for 2 weeks from now.. So frustrating!

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