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've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      · 0 replies
      1. This update has no replies.
    • Mr.Kantos

      Just signed up. Feeling optimistic.
      · 0 replies
      1. This update has no replies.
    • Frugal

      Welcome to Frugal Testing, where we are committed to revolutionizing the software testing landscape with our efficient and affordable solutions. As a pioneering company in this field, we understand the challenges faced by startups, small to medium-sized businesses and any organization working without budget constraints. Our mission is to deliver top-notch testing services that ensure the highest quality of software, all while keeping your costs in check.
      Frugal Testing offers a comprehensive suite of testing services tailored to meet diverse needs. Specializing in different types of testing including functional testing, automation testing, metaverse testing and D365 testing, we cover all bases to guarantee thorough software quality assurance. Our approach is not just about identifying bugs; it's about ensuring a seamless and superior user experience.
      Innovation is at the heart of what we do. By integrating the latest tools and technologies, many of which are cutting-edge open source solutions, we stay ahead in delivering efficient and effective testing services. This approach allows us to provide exceptional quality testing without the high costs typically associated with advanced testing methodologies.
      Understanding each client's unique needs is fundamental to our service delivery. At Frugal Testing, the focus is on creating customized testing strategies that align with specific business goals and budget requirements. This client-centric approach ensures that every testing solution is not only effective but also fully aligned with the client's objectives.
      Our team is our greatest asset. Composed of skilled professionals who are experts in the latest testing techniques and technologies, they bring dedication, expertise and a commitment to excellence in every project. This expertise ensures that our client’s software not only meets but often exceeds the highest standards of quality and performance.
      Frugal Testing is more than just a service provider; we are a partner in your success. With a blend of quality, innovation and cost-effectiveness, we are here to help you navigate the complexities of software testing, ensuring your product stands out in today's competitive market. 
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      I have no clue where to upload this, so I'll put it here. This is pre-op vs the morning of my 6 month appointment! In office I weight 232, that's 88 lbs down since my highest weight, 75 lbs since my surgery weight! I can't believe this jacket fit... I am smaller now than the last time I was this size which the surgeon found really amusing. He's happy with where I am in my weight loss and estimates I'll be around 200 lbs by my 1 year anniversary! My lowest weight as an adult is 195, so that's pretty damn exciting to think I'll be near that at a year. Everything from there will be unknown territory!!

      · 3 replies
      1. AmberFL

        You look amazing!!! 😻 you have been killing it!

      2. NickelChip

        Congratulations! You're making excellent progress and looking amazing!

      3. BabySpoons

        So proud of you Cat. Getting into those smaller size clothes is half the fun isn't it?. Keep up the good work!!!!

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 1 reply
      1. BabySpoons

        That's brilliant! You've done amazing!! I should probably think about changing my profile picture at some point. Mine is the doll from Squid Games. Ironically the whole premise of the show is about dodging death. We've both done that...

  • 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

    ×