DENIED

I got denied. First the lady tried to tell me that I wasnt that big. I didnt have a high BMI. I had to correct her and state I am over 400lbs my BMI is 70+. Then she tried to state that Indiana doesnt allow the surgery to happen on people under 21. Hello I am 23. OMG, I am venting right now. I am so going to appeal. She stated that I didnt provide a psychological exam, I then stated a 3 page letter from my psychologist was labeled in the first set of documents recieved. I am soooooo tired of the run around. I hope I have enought strength to appeal. I am weak with battling with Insurance companies, dont they understand this is a life they are playing with, almost like they get to be God. Its not fair. We have to jump through soooo many hoops just to try and save our own lives. UNBELIEVABLE -Amy A

Hi Amy, I don't know who you talked to or what their position in the company is, but I would talk to someone higher up. Obviously, that person didn't know her a!! from a hole in the ground I would try calling first and take down names etc who you talked to. Sounds like they are just blowing a bunch of smoke. How about a pier to pier review from your doctor? Your doctor would call your insurance company (get the right number for him to call and a reference # or case #) and have him call their medical review or nurse or doctor that has to do with the denial and talk with them. That is how I got my denial over-turned. GOOD LUCK Cindy-Michigan City

your in the fight for your life, ins co want you to go away...you stand up and you get with it gal...appeal appeal appeal...see what the letter states as to why you were denied...if it is what this woman stated then it would have to be turned around...as their facts are all screwed up....call back and talk to someone else, and yes many ins are now giving case workers with the case....you have to do it...this is your life your talking about, come any time and gripe all you want..but you have to appeal and be a loser....keep your chin up gal, looks to me like they have messed up..

Appeal, appeal, appeal....get a second wind in ya and go for it. Sounds like it's all a matter of getting them to set their records right. Send in an appeal with all the facts outlined on your cover sheet. And mention that you are not afraid to get an attorney to help with your appeal. I have a feeling you will get your approval with your first appeal. Hang in there!!!!!!!!

Thank you for all of your support. I really needed it right now. Keep me in your prayers. Amy A

All my prayers for a swift overturn. I sent my packet in on the 10th, and every time I call the insurance company, another person tells me it will be even LONGER before I can even see if I have sent everything I need to (I'm sure I have). The first person told me that if I had sent everything they needed they could have a decsion for me in 48 hours, the next person it went up to 5-7 business days, the next person told me 2-3 weeks and the person I talked to yesterday said 30 days. Everytime they can't give me any info I get even more scared that they are going to deny me too. I call every other business day to see if they can tell me anything new. I called Tuesday and Thursday last week, Monday, and Wednesday this week. Time to call again Friday. The squeaky wheel gets the grease afterall.

Amy Hang in there and fight them tooth and nail for your rights. It took me two years to get approved. Some of it was my fault for not appealing the first time they denied. Then I reapplied and appealed and got approved. You may want to talk to the insurance folks there at St Vincents and see if they can make a call for you also. I really think that these insurance companies like to play their silly little game, like hide the paper work and see what they can do to put you off. You will be a winner in this battle and then become a looser. Dan

I agree with the others, appeal, appeal, appeal. My best friend was denied by Anthem the first time and she needed (2) total knee replacements and a hip replacement and they wouldn't do it until she lost the weight. Her appeal didn't take too long and it was really quick when she found out that she was approved. I would contact the bariatric coordinator where you are planning the surgery, they usually have alot of experience with these situations and how to get around them.

Amy, I have to second & third what everyone has said here-appeal-appeal!! It took me 2 trys because I didn't have the "proper documentation for supervised weight loss". Be sure to get in touch with your Bari Surgeon & let them know what is going on. They had such good advice for me. I wish you all the best-you deserve it!!! Remember to keep your chin up, & keep at it!! (((hugs))) Ellen

hold tight Amy, I just went thru this with Anthem for two months. One day the have not saw the parpers, the next day im denied , and then they are on someones desk but there are pages missing. Chin up....i called them 3 times a day and record all names and conversations because they do and they can go back and look. I pulled out my files and the last lady that i talked to said "enough, lets get this handled and prmised me a phone call back daily till it was determined. She only called twice and the second one was a message on my cell stating that i was approved.