Peer to Peer review!

brttnyj89
on 4/4/18 5:25 pm

So frustrated with my insurance at this point! I have BCBS TX and after waiting for 30 days my pre determination was denied! My doctor is doing a peer to peer review tomorrow at 1130. Has anyone had success with this?

sparty
on 4/4/18 7:32 pm

Revision on 08/16/18

I just went through this process with UHC for a revision request. Based on the reason for denial, my clinic felt they did not fully understand the issues I am experiencing so they requested a peer to peer. During the call they told my Dr if they faxed over an appeal with some additional documentation that they would approve the revision. My clinic sent over the paperwork right away and my insurance approved it 2 weeks later.

Good luck to you!

brttnyj89
on 4/4/18 8:10 pm

I've been told that sometimes they approve over the phone! I'm hoping for a decision tomorrow!

Lo82
on 4/5/18 5:15 am

RNY on 12/19/17

My insurance denied me twice before my surgeon had a peer to peer call. Once he had that call, they approved the same day and I had my surgery the very next week! Good luck!

RNY: 12/19/2017. Height: 5'5. Highest weight: 287. Weight at beginning of process: 276.4. Weight at start of pre-op diet: 270. Surgery weight: 266.5. Current weight (5/20/2019): 182

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