Denied

3loves · 04-25-2006, 03:16 PM

My heart hurts for you. I wished I could call them myself. :phanvan There are rules and reasons for them, but do you think it would help to get a supervisor involved? I always told them my surgeon said it would take 2-3 mos to get a surgery date after approval (which is exactly what I was told....I was flexible being a SAHM and got in sooner) and I needed to move this along as quickly as possible.

Another thing is, I involved a rep that worked for my husband's company (not insurance) since we are self-funded. She really was a tremendous help and put my file into the hands of the PreD supervisor and gave her a deadline. Also, I had my surgeon's office call. They got a bit more info than I was able to on my own. Not sure if this is of any help, but wanted to extend the info just in-case.

I will continue to lift you up in prayer. He is greater than anything we face in life. He is right there with you. This will happen....it's just in His time. I will pray for you to have peace while your waiting. Keep your chin up and know we are here for you as well!!

Mrs Sabre · 04-25-2006, 03:44 PM

Interestingly, Kim at Dr. V's office and I have gotten the opposite result ... they've told me more than they've told her. I know of two others here at NC LBT that have/had the same insurance through the same employer, but were within the guidelines and quickly approved. I believe I've stated my case very well with the letter I sent. (attached)

Up to this point, everything has gone very well. All the doctors, shrinks, etc. thought I'm a really good candidate for LAP-BAND^®. I won't give up without a try. It's just been a very long journey already, and I'm getting tired.

I too believe His will for my life will be done, and in His time. This may simply be a lesson in patience.

vericks · 05-02-2006, 08:22 PM

Don't give up, UHC seems to be difficult when it comes to approvals. Appeal and reappeal. So Sorry I feel your pain!
vickie

wavydaby · 05-03-2006, 12:29 PM

Speaking of which, Have you heard anything Karen?

Mrs Sabre · 05-04-2006, 08:34 AM

I called the appeals service center this morning. It's still under medical review; a determination has not yet been made. I'm praying!

vericks · 05-04-2006, 08:55 AM

Keep calling!