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  756 People Lost in total 66570 lbs = 29.11 % Give us permission to add your before & after Weight Loss Photos |   |
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05-16-2007, 08:08 PM
| #1 (permalink) |
| Big Loser |  The answer was NO
Hey Everyone well the insurance company turned me down today  I called the first time and they told me it was due to the fact that they do not cover going from my previous surgery to the DS surgery so that I do not qualify. So I waited and called back and ask again what the reason was for them to read it to me. They told me that they could not do that all they could tell me was that I was denied due to not meeting the 5 yr dr. supervised weight loss. They said they called my surgeon and gave them information. But of couse I got NO call from them  It was to late for me to find out anything. But the insurance company told me to start the appeal process right away. So now I don't know what is next.  I just feel so sad and depressed. So now the appeal!!!!!!!!!!!! and I don't have a clue how hard that is and what the sucess rate is with that |
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Yes, you can often get insurance cover for your Weight Loss Surgery. Our own Craig "Big-T" Thompson has been there and done that, and he's written an e-book about it.  |
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05-16-2007, 09:20 PM
| #2 (permalink) |
| Seasoned Veteran  Join Date: Apr 2007 Location: Mount Vernon, NY
Posts: 7,738
Weight Statistics 4/1/07 Start Date:
4/19/07 Surgery Date:
5' 9"
Height:
258 lb Start Weight:
158 lb Current Weight:
165 lb Goal Weight:
100 lb Weight Loss:
-7 lb Lb Left to Lose:
38.7596899225 % % Lost:
04/19/2008 Goal Date:
Body Mass Index 38.0957781979 BMI Start:
23.3299726948 BMI Current:
24.36357908 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass    |
Hello there. Please dont give up. If its appeal time, let's get started. Dont let this minor set back ruin everything. A lot of times insurance companies say no thinking you wil give up right then and there. Please dont give up.
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05-16-2007, 09:50 PM
| #3 (permalink) |
| Seasoned Veteran  Join Date: Mar 2006 Location: NYC ~ Love it!!!
Posts: 2,997
Weight Statistics 4/19/06 Surgery Date:
5' 8"
Height:
333 lb Start Weight:
175 lb Current Weight:
155 lb Goal Weight:
158 lb Weight Loss:
20 lb Lb Left to Lose:
47.4474474474 % % Lost:
010/19/08 Goal Date:
Body Mass Index 50.6269463668 BMI Start:
26.6057525952 BMI Current:
23.5650951557 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass  |  I COMPLETELY agree..... ...with Kenyar!!! Let the Appeals begin....get the e-book on his sight! It talks about what to do and how to appeal.... ____________________________________ Weight Loss Surgery Insurance Secrets (eBook)  MORE INFO Discover how insurance carriers decide whether to pay obesity surgery, and improve your chances for getting covered. This is an eBook and will be electronically forwarded upon purchase. Price: $29.95
__________________ Deborah  Lap RNY Gastric Bypass follow my "Journey and Progress" at www.femmemodeweightloss.blogspot.com    |
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05-17-2007, 02:24 AM
| #4 (permalink) |
| Super Moderator  |
DO NOT GIVE UP!!!! Since the ins co said to start appeals, just do so. The fact that they say appeal means there's a very good possibility they will reconsider. Just remember, you will have to speak their *insurance* language, ordinary English, they do not understand! ((((((((HUGS)))))))
__________________ "In every job that must be done, there is an element of fun."   Just a li'l bit 'bout myself  Last edited by DocSanae; 05-17-2007 at 04:05 AM. |
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05-17-2007, 03:59 AM
| #5 (permalink) |
| Seasoned Veteran  Join Date: Mar 2007 Location: Floyd County Virginia
Posts: 3,614
Blog Entries: 1 Weight Statistics September 19th 2007 Start Date:
September 19th 2007 Surgery Date:
5' 10"
Height:
363 lb Start Weight:
211 lb Current Weight:
165 lb Goal Weight:
152 lb Weight Loss:
46 lb Lb Left to Lose:
41.8732782369 % % Lost:
12/31/09 Goal Date:
Body Mass Index 52.0793877551 BMI Start:
30.2720408163 BMI Current:
23.6724489796 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
As I told you before appeal it ! That appeal goes straight to the medical director. Your surgeon writes the appeal letter. It may be wise to see if you qualify for the RNY. I have not seen many post for the switch procedure and really dont know how it works. I just seen pictures. When you get the denail letter they will tell you why. That is your amnunition to fight it. Its not over yet. I hope this finds you well sweetie.
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05-17-2007, 06:02 AM
| #6 (permalink) |
| WLS Mentor  Join Date: Aug 2006 Location: Milford Kansas
Posts: 1,205
Weight Statistics 09/01/2006 Start Date:
5' 4"
Height:
254 lb Start Weight:
144 lb Current Weight:
140 lb Goal Weight:
110 lb Weight Loss:
4 lb Lb Left to Lose:
43.3070866142 % % Lost:
02/01/2008 Goal Date:
Body Mass Index 43.5942382812 BMI Start:
24.71484375 BMI Current:
24.0283203125 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
I'm with everyone else, if this is something you truely want please appeal and don't give up till you get what you want!!!
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05-17-2007, 08:57 AM
| #7 (permalink) |
| Big Loser |
Hi Everyone, Called my surgeon today and of couse the lady started out with a attitude as she always does,telling me she knew nothing about the WHY part that they did not give her the reasons but they told her they would be sending them and me a letter. She then says we can not do anything until we receive the letter telling us why they turned you doWn. I said ok and was about to hang up and she said Miss Dona "Sweetie" if you get your letter in the next day or two you may fax it to us and we can then get the ball moving. For some reason they seem to send the patients letter out first. So just call our office when you get your letter to see if we got our letter and then if not you can fax us yours and we will then take a look at it and see what it is we need to do to appeal. WE don't want you spening time and money on doing things if it is something simple that we can take care of..... does this make since to you HON?" I told her yes and thanks and she said in a very nice voice your welcome and we hung up. So now I wait until I get the letter. |
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05-17-2007, 10:22 AM
| #8 (permalink) |
| WLS Master Guru  Join Date: Apr 2007 Location: Upstate New York
Posts: 687
Weight Statistics 6/16/2007 meda-fast Start Date:
July 19,2007 Surgery Date:
5' 6"
Height:
325 lb Start Weight:
201 lb Current Weight:
150 lb Goal Weight:
124 lb Weight Loss:
51 lb Lb Left to Lose:
38.1538461538 % % Lost:
no time line i just want it to be lost Goal Date:
Body Mass Index 52.4506427916 BMI Start:
32.4387052342 BMI Current:
24.2079889807 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
Appeal it! Don't give up! We are all fighter thats why we can get through this hole prosses. It's a bumpy road look at this as just another pot hole.  fight for what you want!
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05-18-2007, 08:24 AM
| #9 (permalink) |
| Seasoned Veteran  Join Date: Mar 2006 Location: NYC the best place in the world to live!
Posts: 2,986
Weight Statistics Halloween 2005 Start Date:
4' 11"
Height:
212 lb Start Weight:
127 lb Current Weight:
130 lb Goal Weight:
85 lb Weight Loss:
-3 lb Lb Left to Lose:
40.0943396226 % % Lost:
Body Mass Index 42.8141338696 BMI Start:
25.6480896294 BMI Current:
26.2539500144 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
Hi there. Im so sorry that you have to now go through another process to get this approval however its worth the fight. I am going to keep you in my thoughts and prayers for a quick appeal process with positive results. Hang in there and keep that chin up. Fight Fight and Fight it some more. LittleLisaMarie 
__________________ LitleLisaMarie 4'11"{dont laugh}   |
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05-18-2007, 11:14 AM
| #10 (permalink) |
| WLS Master Guru  Join Date: Mar 2007 Location: Louisiana
Posts: 899
Weight Statistics 4/23/07 Surgery Date:
Height: 385 lb Start Weight:
257 lb Current Weight:
190 lb Goal Weight:
128 lb Weight Loss:
67 lb Lb Left to Lose:
33.2467532468 % % Lost:
Body Mass Index 62 BMI Start:
41 BMI Current:
Weight Loss Method Roux en Y Gastric Bypass |
Don't give up, just keep trying. Don't let it defeat you, you will prevail. Roz
__________________ Too Blessed to be Stressed  |
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