Not only did I submit my appeal, but because they used the "investigational" gimmick in their denial, I was able to bypass waiting for them to return and answer and go straight to the CA Dept of Managed Health Care for an Independent Medical Review!  So I have effectively Double Whammied the insurance!!!  Oh! and I sent a nice 81/2 X 11 inch picture of myself so they can put an face with a name too!

I will keep you all posted!

I called Anthem BCBS today for a status update and was told the UR board denied the VSG.  Funny how they like to play these stupid games.  The VSG is covered under my plan but they pulled out the "investigational" card and in the denial said that the RNY or Lapband would be more appropriate.  I completed my first denial over the phone with a letter I had waiting for this day that I read almost verbatum to the grievance department (tweaked to address the language of the denial letter).  I feel powerful... I say "Bring it!" because I am ready!!  They have no idea who they are dealing with!!!

Okay, so what does that mean exactly?  And is it a step on the road to denial?  What can I do to get over this step and into "you're approved" land?  Hmmm...

Anyone who has followed my blog since May would agree that this year has been a bit of a roller coaster ride for me.  2 hospitalizations, 1 surgery (so far), followed by a thyroid problem, and tests pointing to an (as of yet) undiagnosed autoimmune disorder (with the added "scare" that it could be lupus, rheumatiod arthritis, or another debilitating illness) have made me realize that I need to lose a significant amount of weight to help me kick some or most of my health issues.

Yesterday I called Anthem BCBS to verify they are in receipt of my file to get precertified for my sleeve.  Indeed, they have it and told me I will have an answer tomorrow...

I know that the CPT code is approved, so it will all come down to whether they want any more information or that my bloodwork doesn't look good enough for surgery.  I think I will overcome both of those issues.  

Here's to keeping a positive attitude and patience.  Stay tuned friends! 

I finally got my clearance letter from my PCP and turned it in last  Tuesday as I was headed out of town.  So now I just have to stay on Dr Podkameni's office staff to get the insurance involved now.  I don't really anticipate any problems with my insurance but I have read too many stories of getting denied that I have my appeal letter ready to go... Now can we just get it turned into the insurance Please!!  If anyone knows how to get Dr P's staff to answer emails and do their job, let me know!