If you were denied based on not having co-existing life threatening co-morbities...

Busy · 11-17-2006, 09:06 PM

I contacted obesitylaw.com for legal advice and talked to Kelly Lindstrom. She told me there is a program backed by the makers of the Lap Band that if you are denied based on "none life threatening co-what evers", obesity law office will do the appeal and not charge the patient. (I am assuming the manufacturers of the band reimburse the law office or maybe they are that supportive of the band) Anyway, the request for their help has to come from the surgeons office; therefore, I contacted my surgeons office today and gave them the information, they contacted Ms. Lindstrom in CA, she faxed the info to the surgeons office who faxed info to me. I have already completed the application and will fax it back Monday morning. Ms. Lindstrom said very few people were aware of the program and she wish more were involved. Sounds like an oppertunity.

PJ
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beesam · 11-25-2006, 05:45 PM

i also found this info from them, but via email. I'm waiting for my surgeon to come back from vacation to get them to advocate for me. thanks for the info and please let me know how you make out. My surgery was scheduled for 12/8, and still is, but denial came thru 11/20, so surgery is in serious jeopardy.

Busy · 11-25-2006, 06:11 PM

I received an e-mail from them on Wednesday and was told they had accepted my case and were in the process of writing a letter to my insurance company. Somewhere I heard they have had very good results and usually within a 30 day time period so I'm thinking maybe the beginning of the year for surgery if this works out.

myturnow · 12-14-2006, 07:51 AM

I got the news on tuesday... so bummed out... I also found out that the dr.office has an atty that works just like you mentioned above.. no charge to me.. my bmi37.7 if only I had a 40 !!! kinda makes me mad I lost on the 6 mo. supervised..so I am waiting again.. kinda nice to know I;m not alone.. myturnow...donnaco

Busy · 12-14-2006, 06:34 PM

I got an e-mail from Obesity Law this morning saying they were finalizing my appeal and were preparing to fax it to Humana. They sent me some forms to sign and fax back to them giving them permission to represent me and to request medical information. Would be nice to have surgery in January but I don't think things will move that quick if I get approved. The waiting is killing me. So are you fighting the denial??

myturnow · 12-15-2006, 06:30 AM

Yes I feel like if the advocates will help I should let them... I filled out those same forms and mailed off yesterday. Time will tell.. now I have to tell myself be patient.. so hard to do...but we will have the option of self pay if all else fails.. I think we will know in 6 mo or less. what do you think? what are your co morbidies?

flabuless · 12-15-2006, 03:41 PM

Best wishes to you All I hope the new year brings better news for you.
keep us posted.
:) becky

Busy · 12-15-2006, 06:54 PM

Becky, thanks for the well wishes, looks like you are doing fabulous on your weight loss.
Myturnow, my comorbities are arthritis in my knees and hips, gerd, high blood pressure and tired of being fat!!! I expect we will know something within the next few months but I have been on this journey for over a year now. I am at the point that I am researching self-pay just to be ready if things don't go my way. What about yourself?

myturnow · 12-19-2006, 02:27 PM

I heard from obesity law and they were very nice telling me I did not have co morbids needed to be using their services unless I wanted to pay for them.... so I decided maybe i should re-request the claim on the new heaver weight. I have put some on... and my pcp can write a letter and if I am 40 bmi...well thats all it should take.. what do you banders think I should do??? thanks for listening... myturnow...donnaco:paranoid