Insurance DENIAL

Got word today that my insurance has denied my procedure....I have a secondary but was told the insurance personnel at my doctors office..."dont look forward to them covering it" I thought that wasn't nice for her to say....but I guess she was just being rudely honest. Have any of you been denied? If so did you appeal it?

My insurance only covers RNY and lapband and neither of them were okay with me after researching them fully.  I went to Mexico and got sleeved with Dr Alvarez, self-pay.  MUCH cheaper than in the states and much better care as well.  Good luck, I hope you can get it approved but if not, don't give up.  Just look at other avenues.

Forgive me, but what makes him so much better? That seems like a bold statement...

I was that experience for you? How long did you have to stay there?

I haven't been denied this time around but about a year and a half ago (previous employer, different insurance) I was denied for the lap-band because they felt I lost too much weight on my own, that I didn't need surgery. Glad now they denied me because I know the lap band isn't right for me.

I was flat out denied. No chance for appeal. I did self pay with same dr I would have used with insurance. Good luck.

 Every insurance is different.  Your insurance may have an appeal process, or allow the surgeon to do a peer review where he talks Dr. to Dr. with someone at your insurer.  

Also, call you insurance company and talk to them.  I was denied for about 3 hours when I scheduled my surgery, but it was a mistake.  It could be that your surgeons office mad a mistake with the procedure code they entered when going for approval.  

I would advise you to pick up the phone and talk to someone before electing for a self-pay or a surgical vacation.

Thanks, yes I have been making calls and its so depressing....I'm starting to feel like I'm being a bother to the these ppl. They are giving me no hope.....talking about 2yrs from now and gain 20lbs...I'm so down.

 Remember, these people work for you.  These people at the insurance company are paid with your premiums.  You deserve their time and their respect.  

If you are talking about people at your surgeons office, remember that YOU are HIRING them to help you control your obesity.  If they aren't being helpful, you can take your business elsewhere.  Your surgeon is your guide and your coach through this journey.  IF ou don't feel like you are getting the support you need, you can always go somewhere else.

I was also denied by my insurance.  The doctor was amazing but his 2 insurance ladies were absolutely not.  They said many unprofessional statements to me.  I had different statements from the insurance and the doctor's office ladies about why I was denied.  So....... I switched doctor's!!  I hope it goes through but the denial the first couple of times was so heart breaking that I don't want to get my hopes up this time.  I have been trying this for over a year and am not going to give up.  Don't give up!!