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

Denied Today by BCBSNC medical society



Recommended Posts

I called into my insurance company today to check on my approval before the holiday to find out that I have been denied. They said that the only thing they could tell me was "not medically needed". So how can I prove it is needed. Should I get my PCP and surgery DR to help the the appeal letter. Does anyone else have BCBSNC and been denied? How many people usually get denied and the win their appeal? I am just so confused and want to get the appeal process going.:)

Share this post


Link to post
Share on other sites

I am waiting on mine now, I have B/C B/S OH. I am so worried and hate waiting.

Did they tell you why they thought it wasn't? What is your BMI? Mine is a 38 or 39 in that area and I am so worried they are going to say that to me too. Did they give you any reason so you know what you need to fight back?

Share this post


Link to post
Share on other sites

My BMI is 48. And my insurance states that it just needs to be higher then 40 for 5 years and mine has. I hope it is just a clerical error. I will get my letter in the mail this weekend hopefully go from there with what I need to be excepted. They just submitted my paperwork on Monday and it was already denied this morning. So frustrating.........

Share this post


Link to post
Share on other sites

i know if u have bad knees exc.. this could be reason medically n ess.i had knee replaacements last year so i went on the 6 months diet bcbs wanted,and my finally one my dr put medical ness and i was banded tg

Share this post


Link to post
Share on other sites

My BMI is 48. And my insurance states that it just needs to be higher then 40 for 5 years and mine has. I hope it is just a clerical error. I will get my letter in the mail this weekend hopefully go from there with what I need to be excepted. They just submitted my paperwork on Monday and it was already denied this morning. So frustrating.........

I doubt it is a typo, but there could be some additional information needed from your doctor. Try to relax, sometimes a denial can be resolved rather quickly. After the holiday the doctors office can call and find out what the denial is for and should let you know the best & fastest remedy.

Share this post


Link to post
Share on other sites

:eek:Thank you that is what I am hopeing too. That all that is needed is so additional info from my dr. Does anyone know that social anixety b/c of my weight would help with the "medically needed". I just really want to be proactive and get all the right wording and weight symptoms into the insurace so that they know I really do medically need this mind and body...

Share this post


Link to post
Share on other sites

I was denied the first time and my surgeon talked to the ins. company and found out that my sleep study was not included in the original packet. So they resubmitted it to ins. with the sleep study and i was approved. I have sleep apnea and was over 100lbs overweight. So there is always hope. It could be just a simple oversight. Good luck.

Maggies:shades_smile:

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

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Fredeique2020  »  Catherinetheokay

      I am 19 days post op and I am still struggling to drink the fluids. I am not even able to drink the protein shakes their now nasty to me , I tried the protein bars & it didn’t end well. I have chest pains & I can barely eat. I am weak & my mouth is always dry, and feeling nauseous. Can anyone provide any advise. At least I doing the vitamins. Recently my chest & stomach have a burning sensation. 
      · 0 replies
      1. This update has no replies.
    • Crystalmoon

      I am a week post op and I honestly feel like crap! I keep feeling so nauseous and I can’t get my self to drink a good amount of water. I honestly feel very regretful today. When does it get better? 
      · 1 reply
      1. adventuremomof4

        By the third week you will feel some relief. Don't push yourself too much with quantity that first week. I just made sure to keep sipping and walking which helped me feel better.

    • Crystalmoon

      I honestly haven’t weighed myself since surgery, looking forward to doing it! 
      · 1 reply
      1. AAJamesdycle

        Im happy 6251

    • Sarahgirl10

      I have my surgery scheduled for 07/15/2021! I'm so excited! I began implementing the pre-op diet (essentially low carb) that my nutritionist gave me today! So far a pretty rough day- I didn't realize how much I graze throughout the day. But I'm excited to get these habits broken, and take control over my relationship with food!
      · 0 replies
      1. This update has no replies.
    • spatty

      So far the LSD has not been bad. I have had no headaches and no complaints of hunger or cravings. Shake for breakfast, sugar-free jello for a snack, shake for lunch, another for snack, small dinner of protein and veggies and another shake for evening snack with 64 oz. of water throughout the day. I thought it was going to be hell but so far so good. 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×