Denied on May 9th - Page 2 - ThinnerTimes

Godsblessedme · 05-12-2008, 08:18 PM

dont give up sweetie! i did everything my insuranc company said too and got a big fat denied but after 2 appeals the RN reviewing it was dumbfounded as to why i got denied because i followed the requirements and you know what POOF i was approved. I am 4 1/2 months post op so hang in there and give them your fight

astona · 05-13-2008, 12:08 PM

Dont give up... like everyone else is saying FIGHT ... Girl you are a fighter ..... we know it, you have good support. Just find out why you were denied and start from there.. You have not yet started to fight, you can appeal and win..

kellyMASS · 05-13-2008, 03:21 PM

You can and will win this! Its great that you have hubbys support.

Native2u · 05-13-2008, 05:43 PM

Thanks everyone for your kind & supporting words.

I'm going to fight this.....HUGE!! I just have to find out "why" first. The person with my insurance company looked into the file and she said.....that it just said.....Not Medically Necessary.....that's all. I need to know why its not medically necessary.....I think that I have every right to know that, it is my body that we are talking about.

Native2u · 05-21-2008, 09:01 AM

Ok.....found out why my insurance denied me.

They said that there wasn't "proof" that I have been SO for 2 or more years. What do they need, pictures????

I don't think that they even read everything that they have in their hands, MOF....I know that they didn't read any of it. I think that they just denied me, just to do it. I summited proof from the Doctor's office (notes from 2006) and also a letter from me (life story and history) & my parents.

Godsblessedme · 05-21-2008, 09:44 AM

yeah that sounds like they didnt read it. i would still call the review nurse. and talk all sweet

Keep at it honey

Native2u · 05-21-2008, 10:39 AM

Quote:

Originally Posted by Godsblessedme

and talk all sweet

Yep!! That is the plan.

I'm going to call in a few.

BabyNicole · 05-21-2008, 10:53 AM

Quote:

Originally Posted by Native2u

Yep!! That is the plan.

I'm going to call in a few.

Let's say you send them a bunch of pics without a stamped date. How in God's name are they going to know how long ago they were? That "proof" you need is so stupid! Grrr.

Im my PCP letter, my doc wrote that I've been "suffering" with a weight problem throughout my life.

snick1899 · 05-21-2008, 12:04 PM

It sounds like you are right, doesn't seem like they read it all. I hope the appeal goes well for you. Keep me posted! I still plan on diving with you post-op, so I am still confident that it will happen for you! :-)

doxielover · 05-21-2008, 12:12 PM

I'm so sorry about this happening to you. Were you denied after you had been through all of your consults or denied from being referred to the surgeon at all? If you were denied after you had been approved for the consult, then sit down with the insurance expert in your surgeons office and figure out what your next step is. If this happens to me, that's the first place I will run, then after that straight to the board that oversees California Health Insurance. Luckily, I live in the state capitol so it's close! I will keep you in my prayers. April