DENIED

lopezmel
on 8/30/11 5:10 am - Bethlehem, PA
So I received a letter on Saturday that I was denied.    Seems that Capital Blue Cross doesn't accept the Gastric Sleeve.  There are still looking into this type of procedure...seems they don't have all the answers as to what the Gastric Sleeve is, I mean if they approve Gastric Bypass and that's more invasive then why not the Gastric Sleeve...Urgh!!

I spoke to the Dr office this morning and we are going to appeal it.  I need to gather more info from my PCP and send it back to them to submit to the insurance for the appeal. 

Has anyone been denied and had to appeal, if so, any suggestions on what I should do?

Thank you.
(deactivated member)
on 9/1/11 12:23 am - RI
I am so sorry you are going through this!!! I hear you about the sleeve vs. the RNY and being less invasive...but because it's fairly new, I can also see why they would be "looking into it" (I guess...)

Keep your head up!

APPEAL APPEAL APPEAL.... and get that approval!

Fight them until they say yes.

I wish you the best of luck!
lopezmel
on 9/1/11 10:55 pm - Bethlehem, PA

Thank you for the words of encouragement. I plan to do exactly that appeal, I won't give up...giving up is like me saying I give up on myself and I can't do that.  I will get healthy for my family and most importantly for myself. 

Thank you again!

Have a beautiful and blessed day!

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