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Pre-op Gastric Bypass Gastric bypass surgery dates, insurance issues, emotional preparation, etc.

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Old 04-25-2006, 03:59 PM   #1 (permalink)
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Default Denied - Without Even Considering My Medical Problems

Well, you probably won't hear from me for a while. I cannot even appeal my denial. All of my weight management documentation is 3-4 years out. They want it no more than 2 years out. You would think that would have been mentioned somewhere along the way. Nope, it wasn't.

So back through the Sharp program I go. Been through it twice, third time should be a charm. My primary care thinks discipline is the answer...well that just isn't going to cut it with the insurance folks now. They want documents, not mind over matter stuff. I tried to explain and then after almost an hour lecture from my PCP, I just knodded and left and called Sharp.

My neurologist was baffled, since I am in so much pain and suffering. But he won't comment. I am sure it is the professional courtesy they all share. I am a hurting unit and back to supervised weight management. What ticks me off the most, no one ever called from Dr. C's office to say, hey by the way (YOU ARE DENIED).....I had to call them.

You go through so much and you cross your t's and dot your i's and then they kinda forget to tell you some of the things that might come up.

Oh ya, I have a PPO, so I have some bills from this process too, that I wouldn't have had, had I not gone this route.

Denied, feel shorted, and left by the wayside. Still with a medical health problem that no one seem to consider.

b
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Old 04-25-2006, 06:38 PM   #2 (permalink)
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Take heart that everything happens for a reason...I got denied two yrs ago cause my insurance company wouldn't caver and wls. I hated my job and left from a 37,00 a year job to making $7.25 an hour with no benefits ...A few months later I got a new job am now making $48,000 a year , love it, paid off all my debts and had my surgery last wed HOORAY! I know it sucks but sometimes things work out just give it a little more time........
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Old 04-25-2006, 07:12 PM   #3 (permalink)
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Appeal! Appeal! Appeal! Insurance did the same thing to me and they just recently over-turned their decision! Kristy don't give up it will be worth the fight!
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Old 04-25-2006, 07:19 PM   #4 (permalink)
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I am so sorry to hear all that has happened to you ,Kristy - hang in there and appeal. When the time is right and perfect for you, it will happen for you. You will be in my prayers
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Old 04-25-2006, 07:43 PM   #5 (permalink)
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Default don't give up!!!!!

Quote:
Originally Posted by Kristyg34
Well, you probably won't hear from me for a while. I cannot even appeal my denial. All of my weight management documentation is 3-4 years out. They want it no more than 2 years out. You would think that would have been mentioned somewhere along the way. Nope, it wasn't.

So back through the Sharp program I go. Been through it twice, third time should be a charm. My primary care thinks discipline is the answer...well that just isn't going to cut it with the insurance folks now. They want documents, not mind over matter stuff. I tried to explain and then after almost an hour lecture from my PCP, I just knodded and left and called Sharp.

My neurologist was baffled, since I am in so much pain and suffering. But he won't comment. I am sure it is the professional courtesy they all share. I am a hurting unit and back to supervised weight management. What ticks me off the most, no one ever called from Dr. C's office to say, hey by the way (YOU ARE DENIED).....I had to call them.

You go through so much and you cross your t's and dot your i's and then they kinda forget to tell you some of the things that might come up.

Oh ya, I have a PPO, so I have some bills from this process too, that I wouldn't have had, had I not gone this route.

Denied, feel shorted, and left by the wayside. Still with a medical health problem that no one seem to consider.

b
get copies of all your medical records from every doc you went to and check your records yourself, also appeal you denial.
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Old 04-25-2006, 07:49 PM   #6 (permalink)
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That is the way some doc are, I went to the various doc for years and they told me it was all in my head; I had symptoms since highschool. I'm 41 now, in 98 they finally did a test where they stick a needle in your muscle and tell you to flex it. I have a hereditary disease called Charcot Marie Tooth Disease, it took how long for my local neuro to diagnose me.
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Old 04-25-2006, 07:49 PM   #7 (permalink)
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Don't give up! I will keep you in my prayers. Stay with us here any ways, we can still be that emotional safety net for you here while you go through this.
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Old 04-25-2006, 07:52 PM   #8 (permalink)
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I'm waiting for my doc to call, I had pysch eval on 4-24-06 it went great. So I am hoping.
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Old 04-25-2006, 07:54 PM   #9 (permalink)
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I had my psych eval on 4-24-06 it went great, so I'm waiting to hear from surgeon.
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Old 04-25-2006, 07:56 PM   #10 (permalink)
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WOOPS!! can't see in the dark.
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