Denied again

Hello,  I just wanted to let everyone know that I have been denied again.  I have BCBS PPO IL.  I was denied three times first because they were requesting more information. They denied after getting all the information.  We just filed my first appeal and they denied that.  I kinda feel like I am getting towards the end of the rope and it doesn't look good.  They said they are denying me because I show no proof of UNCONTOLLED co-morbidites.  My doctor says that is stupid because if they were uncontrolled  I would be dead.  Anyways just wanted to vent.  Thanks! Kelly

Hello... I just wanted to let you know to hang in there I have Aetna  POSII and finally after a year I have been approved (received the call from the lady in charge of getting approvals at my surgeons office on Friday 7/6/07) they kept denying me at first and when I say it took me a year it was literally a year, when you see people responding and saying 'BE PERSISTANT" please listen trust me it works they soon see that you will not back off and things will happen for you. Good luck and I wish you all the luck DON'T GIVE UP!

Don't give up. I have the same insurance. I just posted a question about their requirments as well. I am a bit scared myself because I don't have 5 yrs. medical history in the form of medical reports. Let me know how it goes. Perhaps your surgeon can fight for you. I have seen people say that helped. Uncotrolled co-morbids? They will think of anything to deny you! BE STRONG!!!!!!

Did you surgeon try a doctor to doctor consult with the insurance company? My surgeon did this when they were trying to say I needed more info. It worked and I got approved!! Hang in there

I have one more appeal left and then it goes to a peer to peer review, when you surgeon calls.  They said they needed info so we sent it. Now they say that the paperwork that was sent in is no contributing any more information to my case.  I swear I HATE ins. companies. I am curious to know approx. how many people with BCBS of IL have had to go all the way to the peer to peer review in order to get approved.  Anyways thanks for the encouragement.  Kelly

I have BCBS insurance too.  They were going to denie me the first time but my surgeoan had been proactive and had called insurance and talked to them before I even got my denial letter.  They agreed to cover my surgery by the time my surgeon got off the phone with them.  I got my denial letter and acceptance letters the same day. LOL.  Hang in there. Shelley

You stay prayerful. I was on medicaid and I just knew for sure that they would deny me. First off I didn't  have any comorbidities. Secondly I didn't have 5 years of a medically supervised diet or weight loss plan. But it has been documented in my medical records that I was obese for a number of years. and I had moved to another state and didn't have all of those medical records. To make a long story short I was told by my surgeon's office (Dr. Vivek Prachand University of Chicago Medical Center) to relax and wait because it could take anywhere from a few weeks to a couple of years......Well I happened to call one day and the nurse was more than shocked when she told me I was approved the first time they submitted the claim, but i had to have the surgery within 6 months or the approval would expire and we would have to start the process all over again.....Don't give up. Good luck.......