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05-20-2008, 05:12 AM
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#1 | | Registered User Thread Starter  
Join Date: May 2008 Age: 48
Posts: 5
| My Insurance Denied Me
yesterday my insurance denied me stated I did not meet the 6 month supervised diet reqiments. Did this happen to any of you and what did you do to fix it?
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05-20-2008, 02:51 PM
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#2 | | Being Banded 5-15-08
Join Date: Mar 2008 Age: 40
Posts: 30
City: Grand Bay State: Alabama | I was denied twice
I was denied twice before i finally got approved...i started my process in August 2007 and was approved in May....what insurance do u have.....keep fighting and dont give up
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05-20-2008, 03:26 PM
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#3 | | Fntasa98
Join Date: Apr 2008 Age: 27
Posts: 23
State: LA |
What insurance do you both have? I am waiting for insurance approval right now and am scared. I have Aetna. What is the reasoning for them not approving you?
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05-20-2008, 03:31 PM
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#4 | | Registered User
Join Date: Oct 2007 Age: 28
Posts: 143
City: killeen State: texas | Quote:
Originally Posted by annetsteph I did not meet the 6 month supervised diet reqiments. | did you do the 6 mo diet? what about the requirements did you not meet?
__________________
Tracy
Banded 3/31/08
in San Antonio by Dr. Stegemann
291 (h) /286 (s) /265.6 (now) /175 (in my dreams)  |
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05-20-2008, 03:39 PM
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#5 | | Registered User
Join Date: Jun 2007
Posts: 60
State: New York |
You just have to jump through the hoops that the insurance company asks you to. You go to your primary care provider once a month. Your PCP keeps a record of your monthly visits, weight checks, blood pressure, your diet attempts like following WW or low carb program and exercise in a log like format.
You don't have to lose a lot of weight( I ended up losing and gaining it back). You just have to follow the 6 months of doctor supervised weight loss attempts. The doctor has to copy his log or documentation and that gets sent to the insurance company. The insurance company figures that some people will give up trying before the 6 months are finished and they won't have to pay for the surgery. I had to wait 7 months because my doctor didn't record my weight on my physical so she wouldn't write in what I told her. Do NOT miss a month. Good Luck.
__________________ Banded 1/31/08 - Dr. George Fielding, NYC 4/30/08 - No longer morbidly obese - BMI 39 |
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05-21-2008, 08:29 AM
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#6 | | Registered User
Join Date: Oct 2007 Age: 31
Posts: 145
City: Lake Bluff State: Il |
I have Aetna as well and I am waiting to here what is going on. I called and they said it's assigned to a reviewer. Which insurance company denied you. Find out exactly what you did wrong on the six month diet. I am sure you can appeal and win. That is just there way they think people will give up. But don't give up. Fight Fight Fight
Good Luck
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05-21-2008, 08:33 AM
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#7 | | Almost there
Join Date: Dec 2007 Age: 52
Posts: 617
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Originally Posted by annetsteph yesterday my insurance denied me stated I did not meet the 6 month supervised diet reqiments. Did this happen to any of you and what did you do to fix it? | I have BCBS of MN. My surgeon's office coordinator turned my paperwork in after three months of a medically supervised diet. I was denied and the letter stated that I would need to do a full six months. After the six months I was approved in a couple of days. Go of the six months and then send in for approval again. Good luck
__________________ 104 pounds gone forever!!!!!!!!!!!!
2 pounds until I reach goal
Band date: June 17, 2008 |
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05-22-2008, 05:00 PM
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#8 | | Registered User Thread Starter  
Join Date: May 2008 Age: 48
Posts: 5
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Thanks everyone for the replies. I am discouraged but not going to give up. I have to hang in for another six months then all should be good.
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05-22-2008, 09:52 PM
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#9 | | Registered User
Join Date: Dec 2007
Posts: 54
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I know that the denial stinks, and I'm sorry to hear about it, but know that it's not over at all, and having to do either 3 more, or a full 6 more months of diet, really will just help you prepare more for the surgery! Both mentally and physically...doesnt feel like it at the moment, but it really is true. This is a life change, so while time is usually the enemy to those of us overweight, when you have the goal in mind of surgery, it makes it easer to focus and find success.
Best of luck!
Tina
__________________
Dr. Marsden - DFW
Banded 12/17/07
1st Fill - 1/17/08 - 3cc's
2nd Fill - 2/18/08 - 1.5 cc's
3rd Fill - 3/18/08 - .7 cc's - total of 5.2 cc's  |
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