Wow Really, how can this be????????

SleeveRockn Chic
on 8/19/11 2:28 am
 I am so upset right now.  I got everything taking care of.  I called Dr. to get results today to see if I still have infection and I don't so I was good to go.  I had spoke with my Dr. office the other day bout some things and asked if they had gotten approval from insurance and they said yep they had and I was happy.  Well today, a few minutes ago my mail arrives with a letter from insurance stating that my surgery has been DENIED Not medically necessary?????  WTFFFF for real.  HOw is it not medically necessary.  I mean to start I am 5'7 and 3/4 cant forget the 3/4 lol and 365 lb. I've been on pre-op diet for a week dont get me started on all the food I've missed lol and I have high BP now probably threw the roof do to this, sleep apnea, sore joints, etc.  How can this happen????? Kerry  

LilySlim Weight loss tickers  
 HW: 365lbs.  SW:353  CW:182.4  GW:160 lbs.
Goal 1: Get under 300 (Reached as of 11/15/2011 299.4 Baby) 
Goal 2- Get under 200 (Reached as of 08/29/2012 199.2 Baby) 
Goal 3- Get to 160
    

koshermama
on 8/19/11 2:30 am
Call your surgeon's office right away and tell them about the letter! THen call the insurance company and complain!!

HW 310, SW 307, CW 259, LW 7.5, Goal 150
    

Shalom aleichem! Join us...  Keeping Kosher After WLS    
SleeveRockn Chic
on 8/19/11 2:35 am
 Yeah been calling and of course the lady I need to deal with and talk to is out to lunch.  Must be nice to beable to eat lol  Can't believe this happens the last business day before surgery.  Thanks for responding :) Kerry

LilySlim Weight loss tickers  
 HW: 365lbs.  SW:353  CW:182.4  GW:160 lbs.
Goal 1: Get under 300 (Reached as of 11/15/2011 299.4 Baby) 
Goal 2- Get under 200 (Reached as of 08/29/2012 199.2 Baby) 
Goal 3- Get to 160
    

Marcia B.
on 8/19/11 2:30 am - CA
You may need to ask your doctors if they reports all the co-morbidities to your insurance and worded that the surgery WAS and IS medically necessary.  Then have them resubmit to insurance
Philippians 4:13 -  I can do all things through Christ who strengthens me.
            
CoolBeans
on 8/19/11 2:35 am - MD
 Hopefully, this is just a mistake that will be resolved on appeal. I know each step forward on my journey I hit some road blocks and it felt a bit like a roller coaster with all the ups and downs. I sure hope that is how this one is for you. 
 Cari    
francislicious
on 8/19/11 2:47 am
OMG I'm so sorry to hear that...U should definitely call your dr's office because they also get the same letter you get. 

Let us know what they tell u....keep ur head up you'll see how god works in mysterious ways!
          
HW: 290 CW: 240 1st GW: 200 GW: 180 HT: 5'8"

AMGent
on 8/19/11 3:29 am
Thats awful honey, thats what happeend to me last year too, i hope its a mistake, keep fighting!! its not over yet.. Just keep calling and finding out whats going on.
LOVING life as a LOSER!! 
              
Lexie 84
on 8/19/11 4:34 am - Washington, DC
VSG on 03/13/12

Those fools probably sent you the wrong letter! You said that the surgeon's office told you that you had gotten approval. The insurance company needs to step their game up. They are playing with people's lives!!!!! I'd love to hear the outcome of this though...it just seems like a mix up, I hope!

            

    

    

    
SleeveRockn Chic
on 8/19/11 4:36 am
 Thank you everyone for your responses.  I called the insurance company and  I was approved for outpatient not inpatient, but doc can make it inpatient if needed and the docs office said they will keep me and not rush me out door so all is good  Surgery is at 10:30 am and 8:30 am for check-in.  Stupid insurance sends me the denial for inpatient but not the approval for outpatient, almost had me spazing, fricking idiots lol.  So I will be sleeved Mon. and can't wait to be a loser lol  Kerry  

LilySlim Weight loss tickers  
 HW: 365lbs.  SW:353  CW:182.4  GW:160 lbs.
Goal 1: Get under 300 (Reached as of 11/15/2011 299.4 Baby) 
Goal 2- Get under 200 (Reached as of 08/29/2012 199.2 Baby) 
Goal 3- Get to 160
    

koshermama
on 8/19/11 5:50 am
Nuts! My insurance was sending me letters even after my surgery - first letter said I was approved for outpatient and my surgeon's office said, don't worry, we can extend it... (they'd said I'd be in for 2 days) Then after I got home (only stayed 1 night, yay!), I got a letter saying I was approved for inpatient... I was like, good thing... LOL

HW 310, SW 307, CW 259, LW 7.5, Goal 150
    

Shalom aleichem! Join us...  Keeping Kosher After WLS    
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