Insurance Denial

[Guest guest]

Hi all.

I have been lurking again...I am sorry that I have not posted in a long

while. I have been busy with getting all my packet info together, starting

back to school and doctors appointments for a bad ankle.

I have been officially denied by my Cigna HMO. I am at first level appeals

now. I contacted Debbie at Dr. R's office and they are going to send me an

appeal letter to mail to Cigna. I also have to write a letter myself. Plus,

one from my PCP.

I am just wondering and thinking ahead....although I am hopeful that I can

have the denial overturned, to anyone that has had to self pay.....if you

also have insurance that would not pay, what are the rules afterward? I mean

if I have a stomach virus after the surgery (if I have self paid) and not

necessarily something associated directly from the MGB, are they going to

resist paying for my medical care for something like that? It says that they

won't pay for any complications or anything to do with the surgery afterwards

if it is a non-covered procedure. I am just wondering how all of that

works.......insurance after a self paid MGB.

Hope all is well with everyone and God Bless.

Dunn

[Guest guest]

MedCost Preferred handled by Acordia National

Re: insurance denial

What insurance do you have?

Alice hardestyal hardesty@...

insurance denial

I just got rejected by my insurance company. I've been 380lbs since

I was 18, 16 yrs i've been 380lbs. My doctor's office didn't have

scales to weigh me, but my insurance company denied me because my

weight was not documented. What kind of crap is that. I've had

diabetes for 14 yrs, i'm insulin dependant. I've had high blood

pressure for at least that long. My eyes have diabetic changes that

can't be corrected. And i've just been diagnosed with sleep apnea

that requires bipap to treat. Has anybody else had problems with the

insurance company and what did you do? Damn i'm frustrated.

[Guest guest]

I am going through the same thing that you are. My insurance will not approve

me without the doctor documented weight loss attempts. But I have Aetna and

there was an easier way out. You can either, on Aetna, go to your doctor and

have your doctor document your weight loss. I would check with them to see if

WW alone will suffice. I would have to go to my doctor and pay for WW at the

same time. What I am doing is a 3 month dietician/doctor supervised program

with the Center for Nutrition at the hospital that I am having the surgery at.

I am paying $500 but that included both of my pre-op nutrition classes and both

of my post-op nutrition classes that I was going to have to pay $250 anyway. I

called my insurance company and got a copy of their exact policy so that I could

make sure that I am meeting all their criteria. They should be able to get that

to you and you can work with your surgeon's office to meet what they require.

I know that it is stupid that they make us jump through the hoops that they do.

I too have been heavy my entire life and have been on diets my entire life. But

I think that they do this to make it a little harder. I think that they think

that if you are not serious you won't hang in there for the long haul and do

what all they require. Just hang in there. If you have decided this is for you

then you do whatever it takes to do it. That is what I am doing.

Dora

insurance denial

I just got rejected by my insurance company. I've been 380lbs since

I was 18, 16 yrs i've been 380lbs. My doctor's office didn't have

scales to weigh me, but my insurance company denied me because my

weight was not documented. What kind of crap is that. I've had

diabetes for 14 yrs, i'm insulin dependant. I've had high blood

pressure for at least that long. My eyes have diabetic changes that

can't be corrected. And i've just been diagnosed with sleep apnea

that requires bipap to treat. Has anybody else had problems with the

insurance company and what did you do? Damn i'm frustrated.