VSG on Thursday - need help with insurance question

(note - I posted this in the VSG forum as well, so please read just once) Hello all, I've been lurking on this board. I have decided to have the sleeve after years of briefly contemplating WLS, and then more recently contemplating the DS. I live in CA and have Blue Shield. My Dr's office tells me that BS does not cover the sleeve anymore - considers it experimental. I am self paying for my surgery on Thursday, but wanted the office to submit the authorization request to have an official denial.  My DR tells me that he has had quite a few cases where the denial comes back with wording that indicates that if the patient chooses to go ahead and self-pay for the procedure, they are now responsible for any complications that arise as well. He thinks it's better for me not to ask for the denial, because then they have to cover complications.  I'm pretty confused and need to decide by tomorrow.  So, here  are my questions: 1) Does any have experience of or know any reason not to get an insurance denial? 2) Does any one have experience or know any reason to get an insurance denial? Thanks much, Roxy

From personal experience as a self pay--if you get a denial they will scrutinize each medical expense after surgery. My insurer often rejects lab work now on me--and it is not cheap! Personally I regret submitting it in writing. For you in the future you will have to make sure all testing and labs have diagnosis codes other than WLS listed, my labwork gets listed as diabetic in order to get it covered now. From my professional experience--we only purposely get a denial if the primary insurer has WLS excluded so we can submit to the secondary insurer. The secondary insurer will not approve until they have it in writing that the first does not cover it.  Good luck! Bonnie

Thanks Bonnie, This was helpful. I'm still surprised the insurers can get away with this, but forewarned is forearmed! Roxy