Post by smkilgore21 on Dec 19, 2011 22:28:20 GMT -5
I tend to be a lurker and was just wanting to not be a lurker anymore. ;D
I have been looking at a revision surgery from the lap band to DS for several months now, I was denied by my insurance the first time due to being non compliant and no mechanical failure.
My surgeon's office submitted an appeal that included documentation of my band slippage as he called it and also included the last 3 years of Dr records from my previous lap band surgeon that showed i had been compliant.
I got a call from the surgeons office today that said they had denied my appeal, and are asking for blood work including a thyroid test and also a letter from my PCP stating i am medically able to have surgery, apparently this is something that we should have included in the original request, yet when i called the insurance company and asked what they needed this was never mentioned.
When i submit the requested information this will be my last appeal and I want to make sure I do exactly what they want. I am just curious if I should also write a letter of appeal plus the stuff they are asking for, or if i should just give them what they are asking for.
Looking for some advice or opinions. When I had my lap band I was approved the first time around so this is all new to me.
I also just want to say i enjoy reading all the very informative posts. I would not know how great the DS is if not for everyone providing the wealth of knowledge and all the great resources for me to research on this site and the other one.
I look forward to my continued lurking, and hopefully talk a little more.
I have been looking at a revision surgery from the lap band to DS for several months now, I was denied by my insurance the first time due to being non compliant and no mechanical failure.
My surgeon's office submitted an appeal that included documentation of my band slippage as he called it and also included the last 3 years of Dr records from my previous lap band surgeon that showed i had been compliant.
I got a call from the surgeons office today that said they had denied my appeal, and are asking for blood work including a thyroid test and also a letter from my PCP stating i am medically able to have surgery, apparently this is something that we should have included in the original request, yet when i called the insurance company and asked what they needed this was never mentioned.
When i submit the requested information this will be my last appeal and I want to make sure I do exactly what they want. I am just curious if I should also write a letter of appeal plus the stuff they are asking for, or if i should just give them what they are asking for.
Looking for some advice or opinions. When I had my lap band I was approved the first time around so this is all new to me.
I also just want to say i enjoy reading all the very informative posts. I would not know how great the DS is if not for everyone providing the wealth of knowledge and all the great resources for me to research on this site and the other one.
I look forward to my continued lurking, and hopefully talk a little more.
