Denied
Hello everyone. Well, the news i’ve been waiting
for 3 months on came in today. I have been denied.
The reason, that I am not medically in need for this.
Do you want to know how much I weigh, 305. <br>I’ve
been crying. I got the call at work so it wasn’t a
pretty sight. I ask about an appeal and they said that
the information is not going to change. I am going to
have to go to my pcp and see if they will send the
ins. something that says everything that is wrong with
me. See BTC’s office sent them a list of what was
wrong with me, but when my pcp sent my files in they
didn’t have anything in there that said what was wrong
with me. They didn’t ask for it. All they said they
needed was my height and weight. Now they are denying me
because the information my surgeon’s office sent was not
on the information my pcp’s office sent. <br>I feel
like and idiot because I went off on the lady, not
real bad, but I was not happy and crushed all at the
same time. Everyone in the office was looking at me.
<br><br>I don’t understand. The information that they are
saying they don’t have from my pcp is stuff like labored
breathing, difficulty walking long distances, sleeping, etc.
I do not need a doctor to tell me that I’m having
these problems because I’m overweight. I never thought
I would need one for this reason. <br>I’m very
upset and now I have to sit at work until 10:00 tonight
thinking about it. I could go on and on, but i’ll just
stop here. <br>Thanks for letting me vent my
frustrations!<br>Brandy
August 11th, 2004 at 10:54 pm
Hi Brandy-<br> I am so sorry to hear that! It
does not mean the end for you though. Keep the faith &
keep trying. Cases like yours make me feel guilty that
it was so easy for me to get approved. I really just
need to count my blessings & thank God for all He’s
done to make this possible for me
August 12th, 2004 at 4:15 am
Brandy, I feel trouble for you. I’m waiting on my
insurance company to send my reply on my surgery. I’m going
through Bariatric treatment Center and they handle
everything. I’ll keep my fingers crossed for you on your
appeal.<br>Heidi
August 12th, 2004 at 9:36 am
Brandy, How devestating. I am sorry for this.<br>Vicki<br>VBG 6-97<br>RNY
6-29-01<br>297/277/150?
August 12th, 2004 at 8:17 pm
Brandy,<br><br>DO NOT GIVE UP. Here is what you
need to do. Get your pcp to write a letter stating
everything that is wrong with you. Also if he has anything
in his files regarding yoru problems he needs to
attach that to thel etter. Get a copy foryoursef to have
on file. Make sure you adn your pcp fax it to the
insurance coming with an appeal letter. At your weight and
with your problems they should not deny you. However,
sometimes they test the waters to see how serious you are
about this surgery. <br><br>DO NOT GIVE UP keep
fighting for the right to have this surgery.<br><br>If I
can be of further help please
contactme.<br><br>Phyliss<br>Surgery 12/14/1999<br>306/156
August 13th, 2004 at 1:38 am
Thank you Phyliss and everyone else. I’m going to
see me dr. and find out what he can do for me. I sort
of went off on the ins. lady yesterday when they
told me I was denied. I woke up this morning and had a
message on my machine from the lady. She said that they
are not trying to get out of paying for it. That they
have to make sure I need it. They are trying to find a
dr. taht I used to go to for phen/phen. He moved away
and everyone in town is having a hard time finding
their files. Some say he is in prison(my luck!) but if
the ins. gets that then they will see that I have
tried something with a dr. I told the lady that I would
go to my dr. and have them record everything that is
wrong with me. So maybe there is hope. This time I’m
going to try to not get my hopes up. <br>Anyway! Thank
you.<br><br>Brandy<br>Preop
August 13th, 2004 at 6:59 am
Brandy, I know how you feel. I found out about my
latest denial at work last Monday. NOT a good day. I had
to let it go for a day and come back to it, because
I just felt so tired from fighting to get this
surgery, as if I have any extra energy anyway! I weigh
435#.
August 13th, 2004 at 5:40 pm
Hi Brandy, <br>Sorry to hear about the denial.
Sometimes we have to educate our primary drs. You would
think with something this important they would send the
necessary info. Don’t give up. Resubmit the request. It
must not have been done right the 1st time. My primary
did the same thing to me. I just kept after him til
he got it right. Good luck. May God guide you on
your journy to the other side.<br><br>Dottie
August 15th, 2004 at 1:45 am
Thanks Kim, I’ll be writing you soon. <br>Brandy