Guest guest Posted January 23, 2004 Report Share Posted January 23, 2004 Well, friends I jumped the hoops as fast as I could and I submitted to Anthem my: -letter of medical necessity from PCP -5 page letter that I wrote detailing my weight loss and citing medical studies in regards to diabetes -got my psych consult done and submitted -got a nutritional counseling done and submitted -submitted 2 weight loss diaries from WW from last year. One for 9 weeks the other for 14 weeks. This all started January 7th, though in reality it was a year in the process. I applied through Cigna and was denied. None of the docs around here really want to deal with them. So I researched and went with Athem after calling all insurance companies during our open enrollment (in October) and asking them to search the policy to see if it was excluded. I used the group number for our company to make sure they looked in the right plan. So then in after my 1/7/04 appt I was upset to learn the Athem was only going to cover them at a paltry $1,500-$7,5000 after 4/1/04. But I went ahead trying to get it done before that deadline. Well, I've succeeded. I was approved in just one day! I can go ahead with the surgery as scheduled on 2/16/04! I felt like I was doing an all out sprint to get this all done in time. I also thought they'd deny me to push past the April 1st day. But they didn't I hope it was the pure force of meeting all the requirements and then some that they had no room to deny. So my procedure is covered 100% less my co-pay, I'm so excited I can hardly take it. I'm scared too. But that's ok. A good dose of reality isn't so bad. F Colorado Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2004 Report Share Posted January 23, 2004 Well, friends I jumped the hoops as fast as I could and I submitted to Anthem my: -letter of medical necessity from PCP -5 page letter that I wrote detailing my weight loss and citing medical studies in regards to diabetes -got my psych consult done and submitted -got a nutritional counseling done and submitted -submitted 2 weight loss diaries from WW from last year. One for 9 weeks the other for 14 weeks. This all started January 7th, though in reality it was a year in the process. I applied through Cigna and was denied. None of the docs around here really want to deal with them. So I researched and went with Athem after calling all insurance companies during our open enrollment (in October) and asking them to search the policy to see if it was excluded. I used the group number for our company to make sure they looked in the right plan. So then in after my 1/7/04 appt I was upset to learn the Athem was only going to cover them at a paltry $1,500-$7,5000 after 4/1/04. But I went ahead trying to get it done before that deadline. Well, I've succeeded. I was approved in just one day! I can go ahead with the surgery as scheduled on 2/16/04! I felt like I was doing an all out sprint to get this all done in time. I also thought they'd deny me to push past the April 1st day. But they didn't I hope it was the pure force of meeting all the requirements and then some that they had no room to deny. So my procedure is covered 100% less my co-pay, I'm so excited I can hardly take it. I'm scared too. But that's ok. A good dose of reality isn't so bad. F Colorado Quote Link to comment Share on other sites More sharing options...
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