TRYING TO GET APPROVED STILL, AFTER 2 APPEALS

[Guest guest]

Hi,

I am trying to get any additional information on getting my insurance

company (Great West Life/OneHealth Plan) to approve this particular

type of surgery. They keep telling me that I've met the criteria, but

that this type of surgery is investigational. I've sent them all of

the information on the website, appeal letters, cost comparisons,

everything I can think of. I do have an appt. with a surgeon here in

Texas on the 26th. But, I don't really want to have an Open RNY,

which is what they do most often. At this point, I'm just about

willing to have any type because of the frustration and desperation.

Is there anyone who has any suggestions or knows of Great West

approving the MGB for someone else. I can use that as leverage.

Please Help!

Thanks,

Cindy

[Guest guest]

hi cindy!! not sure if this will help...but go to ossg here in

egroups...there are about 180 different groups from all over the

us...ossg is obesity surgery support group...there might be a texas

one and also there are insurance ones.....the other site that is

helpful is www.obesityhelp.com...at this site u can look up patients

in your state and see what insurance they have....i would also call

your insurance and see what code they use for gastric bypass and ask

doc if he can bill it under that code...does he take your

insurance????? i hope this helps!!

i just got approved by blue cross blue shield...and i am shooting for

a july 26 date with doc...!! i know it is a long drawn out process

but i think the results are worth it....good luck and email me at

masp99@... if i can help any more!!! mary

[Guest guest]

Cindy,

My insurance denied my first request on the grounds that the procedure was

investigational also. I sent in the appeals letter from Dr. Rutledge, a

letter from my PCP saying he felt Dr. Rutledge was the way to go for me, and

a personal letter, ver personal, describing all my dieting attempts,

failures, how I felt, etc. They approved my appeal. However, I did not

have the same insurance as you. You may call me if you want. My phone

number is .

Kay

TRYING TO GET APPROVED STILL, AFTER 2 APPEALS

> Hi,

>

> I am trying to get any additional information on getting my insurance

> company (Great West Life/OneHealth Plan) to approve this particular

> type of surgery. They keep telling me that I've met the criteria, but

> that this type of surgery is investigational. I've sent them all of

> the information on the website, appeal letters, cost comparisons,

> everything I can think of. I do have an appt. with a surgeon here in

> Texas on the 26th. But, I don't really want to have an Open RNY,

> which is what they do most often. At this point, I'm just about

> willing to have any type because of the frustration and desperation.

> Is there anyone who has any suggestions or knows of Great West

> approving the MGB for someone else. I can use that as leverage.

> Please Help!

>

> Thanks,

> Cindy

>

>

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