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reasons for insurance to deny?



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Hi, Im currently waiting for insurance to approve/deny my surgery. I did everything insurance required, I have a BMI of 37.4 with several co-morbidities. Super nervous about being denied. Curious to see others experiences with being denied and the reasons the insurance denied you?

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Why are you worried? It sounds like you should be approved. What did your surgeon's office say? They likely know why folks get denied and would have mentioned it if something looked off. Good luck, and try not to worry!

Sent from my SM-N960U using BariatricPal mobile app

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thanks for the reply, ya i guess im just a worrier. Coordinator at surgeons office seemed to think I'd get approved but I still worry.

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My coordinator today gave me my surgery date and she hasn't even submitted to insurance. When I asked her why I have a date before sending to insurance she said you are ok you will be approved

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My coordinator today gave me my surgery date and she hasn't even submitted to insurance. When I asked her why I have a date before sending to insurance she said you are ok you will be approved
Wow that's fantastic news! Takes all the worry out of it if they're so sure you'll get approval!

Sent from my SM-N960U using BariatricPal mobile app

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@karenbb, worry is just l8je a rocking chair, it does give you something to do but gets you nowhere!

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My coordinator told me that a lot of denials are based on the verbiage in the medical records and missing information. If you have a good bariatric coordinator that knows what the insurance companies are looking for then you probably don't need to worry.

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Don't worry! I am fortunate my insurance turned around the approval within 3-4 days, but those 4 days were scary and nerve-wracking. And for no reason. Insurances I think are getting the hint that it's better to pay for this surgery than to pay for years of prescriptions and doctor visits, etc.

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