Woo-hoo! I finally got approved!!!
A few of you have seen me on the boards in the past few months or so. I have been at this process for almost THREE YEARS and just finally got approved today about two hours ago! Yesterday, I made the dreaded call to my insurance company. It had been 30 days since I filed my most recent (fourth) appeal. They informed me it had been denied because I had no proof of psychiatric clearance, medical clearance, weight loss attempts, or comorbidities. I laughed. And then I started crying. I had no idea how she could say that when I had submitted my info so many times. I told her that it was all in there, unless my PCP or medical group left something out. This woman was an angel and in a moment you will understand why. She walked me through 68 pages of appeal documents, and then 47 more from a previous appeal, and finally 32 more from my initial appeal. She had to search through page by page to find all the info they stated was "missing". She then compiled a very detailed email and sent it to her manager, who reviewed it with the nurse, who requested an answer from the physician TODAY because of the "mix up". So when the manager called today, she stated the mixup was that they started a new appeal instead of combining them, which could have been responsible for the previous denials as well. UNBELIEVABLE! I hope this helps someone else.
The bottom line is that I AM APPROVED and will be having surgery in the next two to three weeks!!! YAY!!!! I can't wait to be on the other side of the bench and join you all in your triumphs and challenges.
__________________
Kim
Day of surgery: 10/28/09
Highest Weight: 260
Day of Surgery Weight: 233.5
Current Weight: 233.5
Goal Weight: 148
Height: 5 feet 8 1/2 inches
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