Insurance approved for band removal but denied for RNY :(
I am do disappointed and frustrated...I have jumped through every hoop they wanted me to and got the phone call Friday that I was denied for the surgery but they will take my band out. The coordinator at my dr's office said they would file an appeal but I am so bummed that this happened. My hubby is going through the same process and got approved in 4 days with the same insurance...I am happy for him but wish that things were going more smoothly with mine.
Has anyone else dealt with insurance denial but then getting approved?
Any suggestions or ideas on what I need to do to get approved?
Thanks for reading and please think good thoughts that the appeal is approved!
Thanks so much! Jennifer
Has anyone else dealt with insurance denial but then getting approved?
Any suggestions or ideas on what I need to do to get approved?
Thanks for reading and please think good thoughts that the appeal is approved!
Thanks so much! Jennifer
Just keep fighting. Insurances almost always deny things the first time or so. They hope people don't fight it. I had to fight for some plasics and finally got them approved. It took me two times for my pannit and 5 times for my breast reduction.
My Dr office worked hard and told me not to give up. Hang in there!
Julie
My Dr office worked hard and told me not to give up. Hang in there!
Julie
HW 304, SW 291, GW 160, CW 140 H-5'9.5"
I have often times seen denials overurned on appeal. Sometimes it's a simple matter that one piece of the puzzle was missing in the request that it gets denied. My first suggestion would be to call your insurance Monday bright and early and ask why it was denied. I worked with one case (for a revision) that it was denied because the request somehow stated that the origional surgery was one year ago instead of ten (my only guess is someone forgot to type a zero). Once the correction was made it was approved in almost no time.
Did they give you a reason why it was denied? I was denied for both and am in the appeals process. I live in NC too ;-)
Best of luck.
You should at least get that little plastic devil out anyway......
Best of luck.
You should at least get that little plastic devil out anyway......
Revision Lapband to RNY 2-6-2013 HW: 286 Pre-Op Diet: 277 Surgery Day: 265 Goal: 155 CW: 155
Plastic surgery 8/28/2014: Brachioplasty, mastopexy, & abdominoplasty.
Plastic surgery 1/27/2015: Butt Lift
She rattled off a couple of reasons...non-compliance with the band (which is not true because before I started having issues I had lost 80lbs!)...honestly I was crying so hard that I didn't hear all the things she listed.
I see another dr for a clotting disorder I have and he mentioned that he knew someone at BCBS...am thinking about hitting him up to help me with this since he thinks that it is a good thing for me also.
Thanks for good wishes!
Where are you in NC??
I see another dr for a clotting disorder I have and he mentioned that he knew someone at BCBS...am thinking about hitting him up to help me with this since he thinks that it is a good thing for me also.
Thanks for good wishes!
Where are you in NC??
Jennifer in NC (banded 09/08, band removed 11/19/12, approved for RNY 02/14/13, Surgery 2/27/13)
On October 20, 2012 at 5:18 PM Pacific Time, ncbrwneyedgurl wrote:
She rattled off a couple of reasons...non-compliance with the band (which is not true because before I started having issues I had lost 80lbs!)...honestly I was crying so hard that I didn't hear all the things she listed. I see another dr for a clotting disorder I have and he mentioned that he knew someone at BCBS...am thinking about hitting him up to help me with this since he thinks that it is a good thing for me also.
Thanks for good wishes!
Where are you in NC??
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
They hit me with non compliance with the band. I am in the appeals process. I have to find out next week. Will let you know if my letter worked.
I have BCBS of NC.
I live in Elon.
This process sux.
Good luck!!!
I have BCBS of NC.
I live in Elon.
This process sux.
Good luck!!!
Revision Lapband to RNY 2-6-2013 HW: 286 Pre-Op Diet: 277 Surgery Day: 265 Goal: 155 CW: 155
Plastic surgery 8/28/2014: Brachioplasty, mastopexy, & abdominoplasty.
Plastic surgery 1/27/2015: Butt Lift
i just went thru the same exact thing, denial for being noncompliant, i went from 234 to 169 but gained all but 10lbs back because of medicines i was put on...my doctors office sent in the paperwork and they denied it again stating i didnt have an ekg then my doctor called in a peer to peer review and told them to check my records, thats one of the requirements to have the lap band removed and they checked and finally approved me for rnyx...my surgery is scheduled for 10/23 and i just got approved on 10/18.. praying it all goes well for you....
Most Active
Recent Topics