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Finally Approved!

  • Replies 15
  • Views 1.3k
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Congrats! I haven't heard of insurance denying anyone until now. What were their reasons, if you don't mind me asking?

Nice!! That was such a cool phone cal to get. I was SO surprised and elated. I felt like I won the lotto.

Congratulations!

Congratulations! It's so good to hear this right now because I'm going through the same thing with BCBS TX. I'm preparing to begin my second appeal on my own. Do you mind sharing the reason you were denied?



Congrats! I haven't heard of insurance denying anyone until now. What were their reasons, if you don't mind me asking?

I was denied because BCBS TX says I must have at least one comorbilty that is not controlled by best practice medical management. Apparently being diagnosed and taking medication is considered controlled. I'm appealing.





On 4/13/2017 at 1:29 AM, sweitzer2148 said:

I finally got that call I have been waiting for! After 8 months and 2 denials my insurance approved me for surgery! I will find out my surgery date tomorrow. Let the journey begin!

God bless hope all goes well.

  • Author

I was denied because I didn't follow their medically approved 6 mo weight checks. I have United Healthcare. They are picky about everything! First denial was because my BMI wasn't high enough until I appealed and told them I also had a comorbitity.


I have BCBS of Alabama and I was denied last year because I couldn't provide one year of medical records. During that year, my long time doctor moved and I didn't find another doctor. Well, they stated in lieu of those records, a person could send in pictures and a letter of medical necessity. After calling and doing several live chats, they finally approved me. It was such a long process because I had two medical comorbidities, 6 months of weight loss documentation, medical records, and pictures. I guess by calling and requesting live chats worked.

@sweitzer2148 Did your policy require your co-morbidity to be uncontrolled?

I believed my doctor's records for the years that I was under her care showed my prescriptions for high blood pressure. I do have a cpap machine. My machine is over 15 years old, but my sister had to get a newer machine with a chip that they can monitor from the doctor's office.

Quote

  • 2 weeks later...

I finally got that call I have been waiting for! After 8 months and 2 denials my insurance approved me for surgery! I will find out my surgery date tomorrow. Let the journey begin!


Hello! Just Bc I'm new at all of this, can I ask any diagnosis' you had that may have held it off?



Hello! Just Bc I'm new at all of this, can I ask any diagnosis' you had that may have held it off?



Mainly Bc I know some conditions get approved right away and some you have to keep trying for. So I was jus curious.


On 4/17/2017 at 2:06 PM, Kat36 said:

@sweitzer2148 Did your policy require your co-morbidity to be uncontrolled?

I didn't know a co-morbidity can be uncontrolled.

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