Dr has NOT submitted my Insurance Appeal 2 months later.

[droose 19]

When my surgery was scheduled (would have been Wednesday), we knew it would be denied but my doctor and nutritionist were confident it would go through on appeal with the proper paperwork.
The denial came back, there was some delay getting information and giving the information to my Dr. before COVID put a hold on surgeries.

When I ask about the status I am told "it's on his desk" and "he needs to write up the information for submission" it has been 2 months with no progress.

All I want is for them to finish submitting everything so that when surgeries are allowed again (possibly as early as 2 weeks) I am ready.

[Lily66 425]

I would get a new Dr.!

[ChubRub 1,702]

I'm sorry, that's annoying! Giving your doc the benefit of the doubt, it could be that with all of the postponed surgeries due to COVID19, he is dealing with patients ahead of you in line so to speak. Hopefully he will get it out this week! HUGS!!

[danielleleigh90 124]

I feel your pain. I had a doctor that constantly wanted to test me for weed (I VOLUNTARILY told them about this). I smoke or use edibles to sleep, I attempted to get on meds but mirtazapine made me gain about 10lbs so I stopped. Anyway, I've found a couple good doctors i'm inquiring about. The first one is requiring that i do 4 months of dietician visits (my insurance requires ONE), so I'm iffy about them. I've set up appointments with another doctor who luckily will accept my documents so hopefully it goes well & things start rolling sooner. Hopefully we both will have our surgeries soon!

[droose 19]

On 5/12/2020 at 6:15 AM, ChubRub said:

I'm sorry, that's annoying! Giving your doc the benefit of the doubt, it could be that with all of the postponed surgeries due to COVID19, he is dealing with patients ahead of you in line so to speak. Hopefully he will get it out this week! HUGS!!

Thanks

He comes highly. Yesterday I received a call that he "wrote a beautiful 4 page letter" and the appeal was submitted. I am relieved that the process has started moving again.

[droose 19]

On 5/12/2020 at 10:43 AM, danielleleigh90 said:

I feel your pain. I had a doctor that constantly wanted to test me for weed (I VOLUNTARILY told them about this). I smoke or use edibles to sleep, I attempted to get on meds but mirtazapine made me gain about 10lbs so I stopped. Anyway, I've found a couple good doctors i'm inquiring about. The first one is requiring that i do 4 months of dietician visits (my insurance requires ONE), so I'm iffy about them. I've set up appointments with another doctor who luckily will accept my documents so hopefully it goes well & things start rolling sooner. Hopefully we both will have our surgeries soon!

I hope you find the right fit! Keep me posted.

[danielleleigh90 124]

8 hours ago, droose said:

I hope you find the right fit! Keep me posted.

Thank you! They moved my appointment up, the surgeon and the team are amazing and they will accept the things i've done so far through this process. I'm really happy I found him! I'm happy they wrote your letter, keep us posted!!!!

[Maryeuh 55]

Thank you! They moved my appointment up, the surgeon and the team are amazing and they will accept the things i've done so far through this process. I'm really happy I found him! I'm happy they wrote your letter, keep us posted!!!!

So how'd it go? Did you get the approval? Excited to hear.

Sent from my SM-N975U using BariatricPal mobile app

[droose 19]

On 5/23/2020 at 2:52 PM, Maryeuh said:

Still waiting for the insurance company, they haven't given a decision yet.

Edited May 26, 2020 by droose

[danielleleigh90 124]

On 5/23/2020 at 4:52 PM, Maryeuh said:

So how'd it go? Did you get the approval? Excited to hear.

Sent from my SM-N975U using BariatricPal mobile app

Nothing yet! Turns out the ONLY thing they cannot accept from my other doc is the dietician visit. So June 1st I have that, rven submission. I’m hoping for a July date so by my bday I’ll be happy and losing! (September 4th)

[danielleleigh90 124]

6 hours ago, droose said:

Still waiting for the insurance company, they haven't given a decision yet.

Hope they give you news soon! Gah the waiting makes me cringe!