Guest guest Posted December 1, 2003 Report Share Posted December 1, 2003 I was denied at first as well, I waited to appeal for 6 mos, because I was depresssed. But when I did appeal I was approved in 4 days. I have blue care network, which is a hmo as well. Good luck to you. sheryl Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 2, 2003 Report Share Posted December 2, 2003 I was just curious how many of you have had to appeal to your insurance company? And how long did the appeal take? How many of you had to appeal more than once? Yes, I'm a little anxious - my appeal is pending with Cigna HMO. I mailed it 11/11/03. My initial request for the RNY was denied because of the " weak " physician supervised weight loss effort. They wanted 6 months, I had 2.5 months, but I also have sleep apnea and pulmonary hypertension, not to mention a BMI of 53! There was a study reported recently on a local tv station that 80% of appeals to insurance companies are overturned! Please Lord let me be in that 80%! Congratulations to those of you who are recent post ops! Sounds like you all are doing pretty good! And to those of you posting recently who are near surgery date and nervous - just look back to the reasons you started this journey in the first place, put your faith in God and you will be just fine! My thoughts and prayers are with all of you! Have a great day everyone. Carol Miami preop (hopefully) Dr. Eddie Gomez Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 2, 2003 Report Share Posted December 2, 2003 Carol, waiting for insurance is really hard. I had to go through 6 months at a weight clinic before insurance would even authorize me to see the surgeon for a consult. Then a 3 month wait before I could see the surgeon. After I saw him, they applied to my insurance, and was only 6 days, but took 2 months to schedule the surgery. I've heard many insurance's do a preliminary denial, and you have to reapply. I've also been told that medical conditions are most often a big factor in getting approval. It's so hard to be patient when you want something so bad, and you want the medical problems to go away. I had a hard time, particularly with Diabetes and damage to the nerves in my feet. During the year it progressed up past the ankles, and the kidney disease progressed, and I was so frustrated that I had to have a year of problems and permanent damage before the surgery. Although I had gone through every possible diet, including accu-puncture, liquid diet, weight watchers 3 times, 5 year in TOPS, a psychologist and hypnosis, (and thought I knew everything), I did learn much from the clinic, and re-enforced the changes that will happen after the surgery. I do wish you a speedy decision from insurance, and don't give up. Apparently it's part of the process for many. Joan C, Calif. LAP RNY 11/18/03 Dr. Higa, Fresno, CA 282/258/140 Appeals Question I was just curious how many of you have had to appeal to your insurance company? And how long did the appeal take? How many of you had to appeal more than once? Yes, I'm a little anxious - my appeal is pending with Cigna HMO. I mailed it 11/11/03. My initial request for the RNY was denied because of the " weak " physician supervised weight loss effort. They wanted 6 months, I had 2.5 months, but I also have sleep apnea and pulmonary hypertension, not to mention a BMI of 53! There was a study reported recently on a local tv station that 80% of appeals to insurance companies are overturned! Please Lord let me be in that 80%! Congratulations to those of you who are recent post ops! Sounds like you all are doing pretty good! And to those of you posting recently who are near surgery date and nervous - just look back to the reasons you started this journey in the first place, put your faith in God and you will be just fine! My thoughts and prayers are with all of you! Have a great day everyone. Carol Miami preop (hopefully) Dr. Eddie Gomez Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 2, 2003 Report Share Posted December 2, 2003 I HAD TO APPEAL 3 TIMES BEFORE I WAS FINALLY APPROVED. I HAVE BCN WITCH IS ALSO AN HMO. SO HANG IN THERE AND DON'T GIVE UP. I HAD TO GO ALL THE WAY UP TO A LEVEL 3 APPEAL THAT IS WHERE I GOT TO TALK WITH THE APPEALS BOARD. I THINK IT HELPED ME OUT A LOT. SO I AM LIVING PROOF THAT APPEALS CAN WORK. I HAD MY WLS(OPEN RNY) ON 10-28-03 AND I JUST WENT BACK TO WORK ON 12-01-03 SO HANG IN THERE. NORA POST OP 10-28-03 292/259/160 MICHIGAN Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 2, 2003 Report Share Posted December 2, 2003 hi carrol. i know of a number of people that prevailed on appeal. i also saw that channel 7 piece about the appeals process. i'm pulling for ya! lori h. > I was just curious how many of you have had to appeal to your > insurance company? And how long did the appeal take? How many of > you had to appeal more than once? > > Yes, I'm a little anxious - my appeal is pending with Cigna HMO. I > mailed it 11/11/03. My initial request for the RNY was denied > because of the " weak " physician supervised weight loss effort. They > wanted 6 months, I had 2.5 months, but I also have sleep apnea and > pulmonary hypertension, not to mention a BMI of 53! > > There was a study reported recently on a local tv station that 80% of > appeals to insurance companies are overturned! Please Lord let me be > in that 80%! > > Congratulations to those of you who are recent post ops! Sounds like > you all are doing pretty good! And to those of you posting recently > who are near surgery date and nervous - just look back to the reasons > you started this journey in the first place, put your faith in God > and you will be just fine! My thoughts and prayers are with all of > you! > > Have a great day everyone. > Carol > Miami > preop (hopefully) > Dr. Eddie Gomez Quote Link to comment Share on other sites More sharing options...
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