WHO Fought & won??

I'llsucceed · March 17, 2005

Wondering if anyone has Blue Care Network in Michigan? Or when you may have been denied & than fought & won. What did you do -what did you send in- who called the surgeon or your PCP(regular dr )? How long did it take?

Jammin & Losin · March 17, 2005

Hey girl ~~~I just wanted to say~~~ FIGHT! GIRL! FIGHT!!!!!! I'm in your corner!!!!! GOOD LUCK!!!

New Hope · March 17, 2005

Christina, what is the reason they're giving you for the denial? Do you know for sure that they cover the adjustable gastric lapband procedure (not the gastric bypass)?

I'llsucceed · March 17, 2005

Christina, what is the reason they're giving you for the denial? Do you know for sure that they cover the adjustable gastric lapband procedure (not the gastric bypass)?

I was told they were both covered - but that wasn't through them directly- but through the docs office.

The problems they stated were #1 the psyc eval. which I believe has been cleared up. My psyc Doc was kind enough to call & ask what was wrong. They actually told her that they didn't think I had a good understanding of what the operation envolved. LOL LOL - way off course on that one. She said they obviously didn't read her review & she was going to re-fax it over & hopes that it clears that part of the disput.

#2 was I had no diet(followed by a doc) this past year. But I couldn't because I had zero insurance & never saw any docs this past yr. So I am S.O.L. on that one. #3 was something wrong with my BMI ratio. My PCP is supposedly calling to dispute that today. I see her tomorrow for a leg problem & will make sure she followed through.

So I was just wondering if anyone else had anything that they did to disput stuff. I think it was Alex who mention getting her GYN to write a letter so I am also attempting that. I lied (just a little) & told each of the docs that the insurance co. said they would over turn their decision if each of them were to call personally & talk to them this week. So far its worked with one;0)