Denied...
You probably are, but see if your surgeon has an insurance specialist and USE THEM. Appeals do NOT have to take that long. I was denied twice and it only took a few weeks to straighten it out. Good luck!!
VSG 7/1/13 with Dr. Jack Rutledge 28 y/o female - 5'10" - HW: 298 - GW: 174 - SW: 290 (-8) - M1: 262 (-28) - M2: 247 (-15) - M3: 235 (-12) - M4: 228 (-7 ~First Stall: almost 2 wks~) - M5: 218 (-10) - M6: 209 (-9) - M7: 199 (-10) Onederland on 1/31 - M8: 196 (-3) 100 lb total loss on 2/2 - M9: 192.6 (-3.4) - M10: 188.6 (-4) - M11: 182 (-6.6) - M12: 175.6 (-6.4) - M13: 173.8 (-1.8) CW (7/8/15): 167 - GOAL reached in 1 Year and 25 Days! - TOTAL WL - 131 lbs
What was the reason for the denial? Hopefully, it was just an administrative issue (e.g. they didn't receive all the documents they requested, etc.) And yes, I concur that you should use your surgeon's insurance people - they know (or should know) all the ins and outs. Good luck!
HW: 274 | SW: 232 | CW: 137 | Goal: 145 (ticker includes a 42 pound loss pre-op) | Height: 5'4"
M1: -24 (205) | M2: -14 (191) | M3: -11 (180) | M4: -7 (173) | M5: -7 (166) | M6: -8 (158) | M7: -11 (147) | M8: -2 (145) | M9: -3 (142) | M10: -2 (140) | M11: -4 (136) | M12: -2 (134) | M13: -0 (134) | M14: -3 (131) | M15: +4 (135) | M16: +2 (137)
I was denied for the sleeve surgery as my insurance had gone to a once in a lifetime policy. I was able to be approved to get the surgery for band removal. I got the band out as I couldn't take the medical problems and couldn't take it anymore. I also appealed to get the sleeve after the removal as I had shown medical need for the band and could prove medical need for removal. I called head of CS and also was able to talk to head of appeals and they talked to my center and their medical review person. I lucked out as the head of referrals had a band and had to have it out within 6 months.
I also had to go thru the whole process to get the sleeve I had to go thru the first time to get the band.
Lot's of pain and hassle but, was the best thing I have done.
Good luck! Get that band out, get any documentation they need and appeal. Just a FYI my centers current Insurance specialist was worthless. I did it in spite of her.