Denied- Big time disappointed

SuMari
on 10/19/20 10:37 am

So, my insurance denied my request to approve surgery citing, "Not Enough Evidence, Lack of Supervised Weight Loss Efforts"

I am so confused!! I went through more than 6 months of visits, food logs, mental health appointment, support group attendance! I've lost a little weight; I have DEFINITELY not gained!

This sucks

Jmm4321
on 10/19/20 11:48 am

Let your drs office handle it, especially lack of evidence. Mine was denied, 1st appeal by drs office denied 30 days later, 2nd appeal denied a few weeks after that, then suddenly approved a few days later.


Insurance companies have to manage the risk of potential lawsuits s saving money by denying procedures.

catwoman7
on 10/19/20 12:03 pm
RNY on 06/03/15

I agree - see if your clinic can/will follow up on it - they're used to dealing with insurance companies.

SuMari
on 10/22/20 4:05 pm

Thank you, I called them a couple of days ago and asked them to get more information

Kathleen W.
on 10/19/20 5:40 pm - Lancaster, PA

Besides what the others have said, just remember one important thing: Never Give Up, Never Give In." Keep fighting the fight to get your health in order. Remember the line from Apollo 13? Failure is not an option.

SW 327
GW 150
CW 126

                                      

Tekish
on 10/19/20 5:53 pm
On October 19, 2020 at 5:37 PM Pacific Time, SuMari wrote:

So, my insurance denied my request to approve surgery citing, "Not Enough Evidence, Lack of Supervised Weight Loss Efforts"

I am so confused!! I went through more than 6 months of visits, food logs, mental health appointment, support group attendance! I've lost a little weight; I have DEFINITELY not gained!

This sucks

All you need to do is fix what they say is broken. Certainly not the end of the world.

Also, READ what they said was wrong, not what you think is wrong.

The reason I say this I'm relatively certain that the denial had anything to do with you not losing weight in your supervised program. Losing weight is NOT a requirement, only that the program is well documented. If actually losing weight was a requirement, the vast majority of us would have been bounced out.

Good luck,

Tek

Jmm4321
on 10/20/20 12:14 pm

Agreed, I gained weight during the supervised weight loss period.

SuMari
on 10/22/20 4:05 pm

very true. I just feel like it's a personal attack, though I know all I am is a number to them.

MKMGirl
on 10/20/20 6:07 am

So sorry to hear this. Don't give up! Keep fighting for your health.

SuMari
on 10/22/20 4:03 pm

Thank you. I'd just a crappy time, I guess. Trying to see the silver lining

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