Yep, but... you might wanna make sure and wait for another person here to confirm it as I am not quite sure. Better yet, why don't you e-mail the Medifast guys because they can give you an answer better...
Yes, I was denied because my BMI was 39.6, instead of 40..
My Dr. said gain a few more lbs. and we will send it back in..
Sure enough the next time went right through. It is helpful to have your.
Insurance co. rules, when you talk with them...
Although I wasn't denied, we were warned in the pre-op meetings that insurance companies will at first deny the procedure. This is why the bariatric team schedules the.
Weeks out. It gives them time to do the appeal and resubmit to the insurance..
I've been told it's a game they play. Keep moving forward no matter what. A year's effort has been invested and that counts for a lot. You are worth every bit of effort that is needed to get the approval..
Ask your team for help and share with them how discouraged this makes you feel. They will be able to let you know what comes next because they deal with the insurance companies all the time..
Just don't give up! Best of luck..
Don;t give up fighting....my journey to.
Was 3 yrs!! Hang in there and keep fighting! It is well worth the weight ;)..
Did they deny you because there is no gastric bypass clause or coverage in your policy or did they deny you based on not meeting benchmarks? When I was denied in the past over no GBS clause, there wasn't anything I could do. But I also wasn't aware of the appeal process back then..
I have bookmarked this site that is basically a guide to the appeal process for gastric bypass and includes a sample letter to help you write your appeal. I wish you the best of luck sweety. Don't give up !!!.
Please don't lose the.
My primary insurance denied my attempt for the GBS and refused to bend and change their minds. My husbands insurance was my second attempt. They too said no, however, they left the door slightly open with the change to appeal. We appealed the decision and I got my family doctor involved at this point, at the advice of my surgeon's office. My family doctor sent all kinds of records into the insurance company telling them that he felt that it was medically necessary to have the.
Done. All in all it took about 9 months to get my approval but it finally happened. Just hang in there and I wish you luck that your insurance changes their minds!..
I'm not sure of the reasoning, but I was told and am LIVING prove most insurance will deny you at least once. Honey, stay with it. I've fought with our insurance for both my self and hubby. I got so ticked off and was ready to give it up I was tired of the aggravation and the doing and redoing, but I always had a friend to tell me, Don't you DARE give up... this is part of the fun games insurance company's like to play. So, I'd pull my bootstraps up really tight and start all over again..
When I was approved, I honestly didn't get excited and the girl from the doc's office said, "Peggy, are you okay? This IS what you wanted, isn't it?" I told her ohhhhh, yes it was what I wanted, but I've been fighting with insurance for so long and was denied or after fulfilling all the things required, then they'd throw something else in, I kept my guard up so high ready for the battle I didn't know how to react when it was approved! Plus, I had talked to our insurance company one on one a day or two before and they had told me it was denied. Now, here was Shannon on the phone telling me it was approved!.
Since I'm 6 days post op and feeling pretty good, I'm going to start pressing the insurance company to get hubby approved. It's mentally challenging, but I don't think I'll strain anything.
Keep after them. I have also been told, If your insurance will NOT budge, you can contact an advocacy group to get information about taking legal action. I REALLY didn't want to go there!.
If your claim is denied and having problems go to your State Ins COMM, that what they are there for...
DO NOT STOP... the insurance compay wants to see you give up...they will push you but you can get this done...keep fighting..sometimes they do this to see how badly you want this...keep fighting on...it will happen, I know a lot of people who had to keep fighting and eventually the insurance paid for it...use your doctors office to help you! Have a blessedday!.
I work in the medical field and have tons of insurance experience. I helped another girl on the site and her.
Was finally approved. If you would like to email me your insurance company name and any other pertinent information, I can guide you through the process. I also sent in a personal letter to my insurance, can show you that letter too...