Recent Posts
I didn't have to do an appeal, so I can't help you. I'm sorry! I just wanted to acknowledge you though. I hope you find help! Can your surgeon's office help you? That is who usually helps with the appeals.
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)
My insurance said that I needed 6 consecutive months of both doctor and nutritionist visits.
I am new to OH and have read that I need to first be accepted for WLS through my insurance before I start the 6 month required visits to see the nutritionist. Can anyone tell me if this is true? I have called my ins., (BC/BS), and asked them if they cover gastric bypass surgery and they said it is covered and then they went into my requirements, out of pocket, etc.
Any help you can send me would be greatly appreciated. I already know about the six months of doctor visits, etc. But, am confused on the first step.
Thanks!
Hi pharmagirl thanks and I will post in the revision forum.
Sorry you got denied. I have read other post of people with the same issues with their insurance co. You might want to post this question on the revision forum as well.
Hopefully they will approval after the peer to peer. Keep us posted.
VSG on 1/14/14 with Dr. Samuel Wasser
I had the lap band placed in May 2006, everything went well and I lost about 90 lbs. I started to have pain at my port site and noticed I no longer had restriction so I went it have it checked out. After the EGD it was discovered I have erosion. All pre op requirements done according to fepblue, but denied due to non compliance. So after 2 submissions to the insurance company now my surgeon has a peer to peer scheduled for tomorrow 1/2/14. Praying everything goes well.
Anyone have this type of experience?
Hi chinamomma I have fepblue and was also approved for the lap band removal but denied the RNY. My surgeon is also having a peer to peer review this Thursday. From your ticker I'm assuming your peer to peer resulted in approval?
T
As we welcome the 2014 New Year, it is a good time for reflection and renewal. OH's Goal System is a great way to start the New Year.
What are some of your goals for 2014? Share your goals here and post them in the Goal section of your profile. With the OH Goals System, you can make your goals private or public so other members can support you.
Let's reach our 2014 goals together! 
Can someone please help me write my appeal letter?!! I have been denied because of my weight in 2011. I resubmitted new documents from my pediatricians office showing i was over 35BMI but they still are upholding their decision of denial. I am going for a second appeal now... SOMEONE PLEASE HELP ME !!!
Hockeymom87 · 0 replies · 727 views
