I was denied 2x in 2009 because I was to small (BMI 38) and then in December I tried again because not trying I got to a BMI of 40.  I have been denied 2x in February and I have 3 nut. visits.  Last one is Monday April 16th then they are going to submit again. Now I am under 40 because I have been following the directions.  I am not getting my hopes up.  If I get denied again I will just throw in the towel and realize I am ment to be fat forever.  I have BCBS Illinois and I meet all the requirements they just are jack a**.

had my surgery at the same place. I prepaid my copay and after all was said
and done, I had overpaid. The doctors office owed me about $400. They would
not refund it because it had already been paid to the hospital. And the hospital
said it was the doctors office who owed me. Well it took 8 months before I finally
got my refund back. So I think I would talk to another coordinator or give her the
name of the person at the insurance company that you spoke too.  How do they
really know how much your cost is prior to the surgery. You are not a bucket of
chicken. They don't know what YOU specifically need prior to surgery.
 What if you only need "one"  aspirin versus "two".

Go get em!!!

Dani

 
They have 30 days to review the info and give you the decision.

I have had the exact same issues. I originally had 3 bouts of internal bleeding and Anemia that almost took my life but after the ulcers where I never felt any pains. I attributed the ulcers to stress and my high stress sales job might be the cause so I switched jobs to a lower paying job doing Mobile Pet Grooming. About 6 months later I started getting stabbing pains anf gas pains that would bring me to my knees. I had already lost my insurance by this time so I was making visits to the ER at the County Hospital. I would rather go to jail then do that again as it would be a cleaner, more attractive environment. I was able to get an endoscopy.  Funny tho at County I assumed I was going to be put to sleep for the Endoscopy but nope, while still wide awake they start jamming a tube down my throat, needless to say the scope was able to go where a scope should not go after GB surgery. Out of desperation I went to my original GB Dr. and he verified it but without insurance
I could not do anything and County was a joke. I started documenting everything, dates, outcomes, all of my reports and paperwork became a file that I carried with me to every Dr.  and I finally broke down and begged my orogonal Dr. to help me file for Disability as I was no longer able to maintain my ability to be gainfully employed. My legs swell to twice thier size, my back hurts all the time, My stomach hurts and now my knees are giving out from the excess water weight. I was able to get Disability after waiting about 9 months to get approved. It got approved the first time around. It might be attributed to my many ICU visits as I hear alot of people have to hire attorneys. It takes time and you cant give up but I now have insurance. I have a repair date set for next month. I have almost gained back all that I have lost and as long as I survive the repair surgery I will be back on the path to feeling good again, except without the stress. Whatever it takes dont give up.

Our plan through BCNM has a $1000 c-pay and it was confirmed earlier that I need to bring the copay with me to the hospital.
I have been trying to have RNY since 2003. Our company changed the insurance carrier, after I was approved. Waited until 18 months ago to try and pursue getting the RNY done...I had to meet with my PCP once a month for 6 months and show proof of taking Phentermine and actually losing weight and then had to meet with a nutrionist. I was initially denied in March 2012 and after the appeal, I was approved and now I am having the RNY done on 4/25/12.
Thanks for the feedback and congratulations to you also...