Insurance

[Lifeafter40 89]

My surgeon submitted my information to my insurance company, My insurance sent it back stating that they needed a letter from my primary care physician. My primary care physician wrote a letter stating I needed the surgery. I was denied by my insurance company however my surgeon did a peer to peer with the insurance company. My surgeon called stating that they need another letter from my primary care physician stating that they she recommend the revision and the letter must have her signed signature. A little history I had the sleeve in 2015 and lost 30 pounds and have gained 30 plus back. Now I want the gastric bypass. Do you think the insurance company will now approve me.? My primary physician will submit a new letter on Monday and then my surgeon will submit the information again for approval. Anyone ever experience this before. My insurance company is APWU

[AZhiker 2,251]

I had the run around from insurance, also. (BCBS). I had to have 6 months of documented PCP visits with attempted weight loss, Then once everything was submitted I was denied because my surgeon's office failed to submit the psych eval. Eventually, it all came together and I got surgery 8 months after the beginning of the process. I am very thankful, however, for this time. It helped me get my head around all the changes, really solidify the decision, and gave me a bit head start in getting rid of sugar, carbs, caffeine, soda, Snacks, BEFORE surgery so I didn't have to deal with those addictions during recovery. I also had a sleep study done during this time which gave me the diagnosis of extreme sleep apnea. This helped push the insurance company, I think, because I didn't have other co-morbidities.

I think you will get approved, The companies just have their process and they have to dot all the i's and cross all the t's. From what I understand, the need for revision from failed surgery is a big push for them to approve.

[Lifeafter40 89]

I got approved today