Good news: I called BCBS of IL today and found out my sleeve surgery was APPROVED!!!!

Bad news: They said my EGD was declined due to being "experimental" and not needed. They won't give my doctor a letter for denial for up to 15 days and my appointment is supposed to be this upcoming Tuesday. I'm frustrated because I do think I have a hernia or a legitimate problem that the EGD will find before surgery.

Has this happened to anyone else?

I would ask what the diagnosis was for the EGD. If you have expressed anything like heartburn, abdominal pain, trouble swallowing, nausea, and/vomiting, then it should be deemed medically necessary. If it's got any of these or other qualified diagnoses, I'd file an appeal. It might be something as simple as not being coded correctly when it was initially submitted.

I would ask what the diagnosis was for the EGD. If you have expressed anything like heartburn, abdominal pain, trouble swallowing, nausea, and/vomiting, then it should be deemed medically necessary. If it's got any of these or other qualified diagnoses, I'd file an appeal. It might be something as simple as not being coded correctly when it was initially submitted.

Agree entirely with this.