Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

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

Share this post


Link to post
Share on other sites

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

Congratulations!

Share this post


Link to post
Share on other sites

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?



Share this post


Link to post
Share on other sites

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.





Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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.


Share this post


Link to post
Share on other sites

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.

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

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

Share this post


Link to post
Share on other sites

[mention=298176]sweitzer2148[/mention] Did your policy require your co-morbidity to be uncontrolled?

Not at all. They just wanted a BMI of 40 or 35 plus at least one co-morbidity.


Share this post


Link to post
Share on other sites

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?


Share this post


Link to post
Share on other sites


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.


Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 0 replies
      1. This update has no replies.
    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×