Gastric Bypass Surgery Support Group
Gastric bypass (GBP) is any of a group of similar operative procedures used to treat morbid obesity, a condition which arises from severe accumulation of excess weight in the form of fatty tissue, and the health problems ("co-morbidities") which result. If you are considering gastric bypass or have had it, join the community where we share our experiences and find support.
I called my insurance company because I am impatient and I was told my authorization for surgery was DENIED on 8/29! I asked them what the reason was, and I was told that they did not receive all required paperwork. I asked them what was missing and was told the psych eval, letter of medical necessity from PCP and all of my nutrition info. WTF!??!!
I called my surgeon's office and spoke with the nurse who handles getting everyone approved and she was aware. She told me she submitted EVERYTHING including what the insurance company claims is missing and she had followed up and was told they had everything and then she received noticed I was denied because stuff was missing. OMG!! So she resubmitted everything again so now I have to wait again. I think I am going to call the insurance company again to see if they have her resubmission of everything.
This is so stressful, you do so much to prepare for surgery for months and months and then the insurance company plays games with you!!
I called my surgeon's office and spoke with the nurse who handles getting everyone approved and she was aware. She told me she submitted EVERYTHING including what the insurance company claims is missing and she had followed up and was told they had everything and then she received noticed I was denied because stuff was missing. OMG!! So she resubmitted everything again so now I have to wait again. I think I am going to call the insurance company again to see if they have her resubmission of everything.
This is so stressful, you do so much to prepare for surgery for months and months and then the insurance company plays games with you!!
Shelley
sorry that this has happened to you. I use to work doing pre-certifications/authorizations and its possible that part of the pages were mixed up with something else. That doesn't make it right by no means but that is why we have to be proactive and stay on top of our medical treatment/care no matter what it is.
Call tomorrow and be sure that they have your new fax in from the office, if not then pester the heck out of the gal at the doctors. Some insurance companies will let you fax it yourself some wont.
I am praying that the appeal which is what it is at this point goes through. Hang in there as i just told someone else things happen for a reason.
I just got a prior certification on a new medicine and now one week later the med was increased the way it is suppose to and now they want prior authoration again. My doc is going to kill me if I keep having a pain in the a** insurance co. Keep on top of them. debby
* I was NOT denied foor a medical reason just missing paperwrk.
* I have NO problem calling the insuramce company.
So like everybody else said - stay focused on your goal and don't give up!!
I was denied - had to do visits w/ different docs - tests after tests - diets - classes -- fighting the insurance every step -- and FINALLY it all lined up.
I'm just looking at it that now is the time it's meant to be.
Good luck ... stay focused!