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This is cross posted to the INSURANCE PROBLEMS, DR. WELKER'S GROUP, and DS MAIN

LIST

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Hey! Guess what! I was denied by Blue Cross yesterday. :(

Really, though, I spoke to (or Kathy???) in Dr. Welker's office and she

told me she'd talked to a woman from BC. The woman said they would not pay for

the DS but I could be approved for a " different surgery. " The woman wasn't

specific but we all know she meant a RNY.

I wasn't mad. I wasn't upset. Why? Because we all knew it would turn out this

way. There was a tiny little part of me that hoped that maybe, maybe I'd be the

first one they'd approve. Not only for me,

but for all the others. Someone HAS to be the one that breaks them down.

Dr. Welker is supposed to call the woman at BC. I don't know what he can

accomplish but I've got my fingers crossed.

I spent the afternoon calling insurance companies for new group health for my

employees (and me). Nothing yet. One man asked for the insurance codes. I

gave him the ones Dr. Welker put on my

LOMN. He called me back and said his company, " Pacific Life " , would cover the

surgery although the patient must be 100# overweight, etc. [i didn't get too

exited at this point because the first two times I spoke to Blue Cross customer

service, they said they covered those DS codes, too!]

Anyway, I asked if he was sure and he said yes. I had further questions so he

gave me the direct line to customer service so I could ask them myself. Now,

get this: Just to verify his info, I asked the girl about the codes. She said

" We don't check insurance codes. That's up to the claims department. " (So, the

guy DIDN'T actually check the codes!!!)

I asked politely to speak to her supervisor. After explaining the situation,

the super said she'd check on the codes and call me today.

Is there a comprehensive list anywhere of the insurance companies who HAVE

approved DS since June? If not, we should try to compile one. And a list of

the ones that DO NOT approve it.

~~Sad ShirleyAnn :(

Pre-op Dr. Welker

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