Denied By Insurance Carrier
Well it happened. I got the letter in the mail
the other day and Coventry is not going to cover my
RnY or any other weight loss method. The day i got my
letter my Dr. had called and said that he has already
scheduled a appeal with Coventry. That was before I had
even called anyone. We have an appeal set for June 6
and my surgeon and PCP will both be there. I am not
hoping for much!!! Today I sent a letter to my Employeer
stating my disgust with thier choose of insurance
providers. The insuracne co. wants to hear any other
information the Dr or Surgeon or I have. Anybody having any
helpful hints please contact me!!!<br><br>Greg
May 17th, 2004 at 5:49 pm
Greg,<br><br>Just read your post. Sorry to hear
you will have to fight for this surgery. First and
foremost, is the surgery covered by your policy. Never mind
what they told you, get out your copy of the policy
and read and see if it is covered. If it is and your
doctors are behind you 100% then they cannot deny you if
it is medically necessary. If it is not covered,
then you will have to fight, fight, fight. Since your
doctors are both on your side, and are willing to go
through the appeal process with you then DO NOT GIVE UP.
I have seen insurance companies put people through
hell and int he end approve the surgery. Just DO NOT
GIVE UP, FIGHT FIGHT FIGHT.<br><br>Phyliss<br>306/150
May 18th, 2004 at 10:39 am
Is this group coverage??? and….if so is it a
self-insured plan or fully insured plan???<br><br>If it is a
self-insured plan your employer has the right to request an
exception be made.<br><br>GOOD LUCK on your appeal!!!
May 19th, 2004 at 12:35 pm
Phyliss, thanks for your encouragement. I just read your post to Greg, and as I
am going thru the same, pretty much, I really appreciate your cheering up.
THANKS!