Care First - denial- awaiting approval

soxshuff
on 11/27/14 2:12 pm - Edgewater, MD
VSG on 12/02/14

Hello All,

Well, I am scheduled for Vertical Sleeve surgery December 2, 2014.  I just found out last week that I was being denied because I was missing a nutrition class.  I was informed of this AFTER I had my pre-op class.  So,I scheduled and attended the necessary nutrition class and should hear today 11/28/14 if Care first is approving my surgery.  Care First did not list any other reasons for denying my surgery except for the missing nutrition class.  Call me crazy, or maybe just someone who likes to plan ahead, but is this even possible to have my surgery approved 4 DAYS prior to surgery date?  Talk about waiting till the last minute and causing me GREAT anxiety!  If anyone has any information they could pass my way about this being normal procedure, I would greatly appreciate it!

 

Member Services
on 11/27/14 2:44 pm - Irvine, CA

No advice, but we wanted you to know we are sorry to hear all you are going through. Please keep us posted

soxshuff
on 11/27/14 5:02 pm - Edgewater, MD
VSG on 12/02/14

I really need some feedback.......good or bad......my anxiety is on overload at this point.  I have done everything required, and now, I panic.  Not only do I put myself on the line, but my surgery is an hour from my home. Any Input would be helpful.  I never wanted the surgery for vanity issues, I just want to run again.  I cannot run in my current weight.  I want to be healthy again.

  

Mary Gee
on 11/27/14 9:04 pm - AZ
VSG on 05/14/14

My approval came at 4:00 on a Friday afternoon, and I was scheduled for surgery the following Wednesday.  I was afraid I was going to have to reschedule--my insurance company took the full 14 days they had to review my paperwork.  I had my pre-op screening the day before surgery.  UGH!!!  The Stress!!

I'd call the insurer this morning and have them pull up the notes re the surgery - tell them you took the missing class and ask what's happening.  Explain you're scheduled for the surgery.  While my claim was pending, my insurer told me I could call every day - they understood my anxiety.

It is stressful - but it's not unusual.  And worst case scenario - your surgery gets delay for a brief time.  Take a deep breath - it will work out.  I'm keeping my fingers crossed for you!

       

 HW: 380 SW: 324 GW: 175  

 

 

 

 

 

 

 

Bubbles314
on 11/28/14 3:18 am - Kalamazoo, MI
RNY on 10/06/14

Like MaryGee said, I would call the insurance company and ask if your approved.  I would also call your Dr office today and ask what they reccommend and tell them you can't self pay.  Good luck

  

soxshuff
on 11/28/14 11:21 am - Edgewater, MD
VSG on 12/02/14

Just wanted to post that I got approval Friday morning!  Starting clear liquids for surgery on December 2

Bubbles314
on 11/28/14 11:27 am - Kalamazoo, MI
RNY on 10/06/14

soxshuff, that's great news.  Good for you.  Good luck on December 2, hoping for a quick recovery, and see you soon on the Loser's bench.

  

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