insurance denial

[Hopep4673 120]

So I am working all my insurance requirements for surgery, and now wondering what if I go through all this and am denied... I know my insurance covers it and I meet those requirements... Knowing me I am stressing over nothing but still does anyone know how common is insurance denial??

[CJ Sunshine 241]

I was lucky enough to be approved first application, no problems. I've read a lot of people had to appeal once or even twice before they were approved.

[catwoman7 10,867]

if your insurance covers it and you meet all the requirements, you should be fine

[HDScarlett 85]

My ins just dropped the numerous lengthy requirements and is allowing sleeves. I jumped on it, and was able to navigate thru the list quickly. Start to finish took me about 2 months. Do Ins companies really think we haven't tried every program out there prior to considering major surgery??? Stupid! They no longer require 6 months of Dr administered weight loss program, but my Dr watched me for a few months, and submitted it just to make sure I would not run into any problems. I was approved 10 days after submission. I hate having to jump thru hoops, but the savings was worth it. Altho, I would have paid out of pocket if denied. Check off the requirements, and you should be fine. Most Drs have a good relationship with the ins claim reps.

[heycrystal2052 430]

I was approved in a day, the only thing I had to do was the 6 month waiting period.

Psych Eval

Six Dietitian meetings, one nutritionist.

[OutsideMatchInside 10,166]

I would check what the requirements are, it is late in the year so if you have to do 6 months of anything, you are going to blow your deductible this year, and then have to meet it next year.

If I had any 6 month requirements I would wait to start next year.

[Hopep4673 120]

I would check what the requirements are, it is late in the year so if you have to do 6 months of anything, you are going to blow your deductible this year, and then have to meet it next year.
If I had any 6 month requirements I would wait to start next year.

I have to have a 6 month medically supervised diet, etc etc same as most... I am on month 4 of 6 and I have my psych next week...

Sent from my SAMSUNG-SM-G930A using BariatricPal mobile app

[heycrystal2052 430]

Do it before the year is over, just in case your policy changes for 2018.

[CJ Sunshine 241]

18 minutes ago, heycrystal2052 said:

Do it before the year is over, just in case your policy changes for 2018.

This is EXCELLENT advice. You never know what policy changes may come. Some people's policies expressly exclude WLS. Besides, you may not feel as motivated then as you do now.

[Hopep4673 120]

my projected surgery month is December... I am hoping to get it done b4 the first of the year bc my deductible is already met. my doctor is aware of that so we are trying...

[angyplus5 470]

if you don't mind, what insurance do you have?

Sent from my SM-S907VL using BariatricPal mobile app

[Hopep4673 120]

BCBS tennessee

Sent from my SAMSUNG-SM-G930A using BariatricPal mobile app

[Siyaa Ela 59]

This is my same fears I have. If they deny me , I prolly will sue them , not gonna lie. You pay for the insurance and they deny you service.. that's not how it works.

[heycrystal2052 430]

On 8/30/2017 at 3:08 PM, CJ Sunshine said:

This is EXCELLENT advice. You never know what policy changes may come. Some people's policies expressly exclude WLS. Besides, you may not feel as motivated then as you do now.

I'm with BCBS and you'll be amazed at how many things we approve and at the beginning of the new year, are denied per the new group policy. If you're approved for anything, get it done that same year. Even if your employer says "some" things will not change, get it done any way.