Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

I am having trouble getting approved from Molina healthcare. My doctor has sent approval saying I need the surgery and they keep not approving it. Can somebody please help me. Thank you 😪

Share this post


Link to post
Share on other sites

is bariatric surgery covered in your particular policy? Policies can vary among employers, even if they use the same insurance companies. Some employers choose not to include a bariatric surgery rider, even if the insurance company offers one.

if your employer's policy DOES cover bariatric surgery, do you meet all the requirements?

Share this post


Link to post
Share on other sites

Yes but it is state insurance and the place that I am trying to get surgery does take my insurance.

Share this post


Link to post
Share on other sites

15 minutes ago, KariLinn said:

Yes but it is state insurance and the place that I am trying to get surgery does take my insurance.

here are the requirements. Do you meet all of these? If so, did they give you or your PCP a reason for denying you?

https://www.molinacenter.com/-/media/Molina/PublicWebsite/PDF/Providers/wa/Medicaid/1023-2009_23924_CM-Provider-Bariatric-Program-Flyer-Update_nob_FNL_508c.pdf

Share this post


Link to post
Share on other sites

Thank you. I have read through that and I have three things on there and they are still not approving me. I have a doctors appointment tomorrow to see what we can do. They didn’t give me a reason they just told my doctor.

Share this post


Link to post
Share on other sites

You should talk to the surgery center about why the insurance is denying you. The insurance company would normally provide a reason for the denial, at least I think they do. And you can call the insurance company and find out the reason. I have had to deal with insurance companies for a chronic illness and it's really a PITA but you can always EVENTUALLY find out why something is denied.

Share this post


Link to post
Share on other sites

Question: what is the difference between a predetermination letter and getting approval for the surgery? I called my insurance and the gal just spoke in circles! Finally have all my pre op requirements completed.....man, this a job!

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

  • Recent Topics

  • Most popular:

  • Together, we have lost...
      lbs
    ×