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Please Help!

I was sleeved on 12/22. I have GEHA Insurance which is Federal insurance. I jumped through hoops and did everything I needed to do for this surgery. I got my pre approval letter in before my surgery. I had the surgery done and here I am thinking how wonderful my insurance is! I get a letter in the mail today from Conifer Health Solutions stating that GEHA transferred my $54,000 claim to them last minute and they decided to DENY MY CLAIM!!! This is all I need after a major surgery. Please if anyone is going through something like this please help me! I am having to look at bankruptcy because this costs half my house!!

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Perhaps they may just need all the documentation from your previous provider and a curremt letter of recommendation from your surgeon. Every insurance provider has an appeal process. I would start there. Also contact your previous provider and ask them whats thier process for approved claims that are transferred to another provider. Thats souds crazy, so did they sell your policy or all of their policies to this new provider?

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  • Author

They I guess just sold this claim because GEHA is still my insurance company. It is crazy. GEHA is connected with United Healthcare. They are supposed to be the best due to my husband working for the federal government. It is nuts that I come all this way and I do qualify for this surgery and they try to yank everything away from me. I've already had the surgery so now I have a big fat bill to go with it.

Sent from my SM-G930V using the BariatricPal App

Don't panic. Call your insurance company first. It was likely a mistake. Second, file an appeal. Get your documents together. Also, pull in your husband's employers benefits people to help you. Get your dr office to help. They have an interest in getting paid and are experts at this.

It will be ok. You just need to make some phone calls.

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  • Author

Update to my original post. I called the person that was on the letter and she told me since that letter (dated 1/10/2017) they have received all the rest of the information they apparently needed and will cover my surgery!!! I am VERY happy about this!! ????????

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