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[C.Caldwell]

Hello my name is Chastiny, Thanks for letting me join!!

 

[hilary1617]

Hi and welcome Chastiny! I see you posted an insurance question on a different thread. What procedure did you have previously and how would you like it to be revised?

 

[southernlady]

Hi and welcome Chastiny! I see you posted an insurance question on a different thread. What procedure did you have previously and how would you like it to be revised?

I moved her insurance question to the proper forum. That way I could get Diana and Larra involved

 

[Munchkin]

Welcome!!!

 

[C.Caldwell]

Hi and welcome Chastiny! I see you posted an insurance question on a different thread. What procedure did you have previously and how would you like it to be revised?

Hello, I had Gastric Sleeve 9/2017 and I lost 31 lbs. My desire is revision to DS. I've been working with my nutritionists since 12 /2021 and have lost 39 lbs. My surgery was scheduled for 9/26/2022, however my Insurance (United Healthcare) denied my prior authorization. Per Rep, revision is only approved for technical failures such as bowel perforation, leaks,obstruction or staple-line failure.

None of the above apply to me, however I have diabetes (Take insulin daily), high blood pressure and high cholesterol levels. My Dr stated I could Appeal, however the surgery scheduler is managing 3 sites and can review my Appeal as quick as possible. So here I am, as confused however still determined to win this fight.

Any help?

 

[C.Caldwell]

Did I enter my reply correct?

 

[southernlady]

Hello, I had Gastric Sleeve 9/2017 and I lost 31 lbs. My desire is revision to DS. I've been working with my nutritionists since 12 /2021 and have lost 39 lbs. My surgery was scheduled for 9/26/2022, however my Insurance (United Healthcare) denied my prior authorization. Per Rep, revision is only approved for technical failures such as bowel perforation, leaks,obstruction or staple-line failure.

None of the above apply to me, however I have diabetes (Take insulin daily), high blood pressure and high cholesterol levels. My Dr stated I could Appeal, however the surgery scheduler is managing 3 sites and can review my Appeal as quick as possible. So here I am, as confused however still determined to win this fight.

Any help?

What is your current BMI?

Did I enter my reply correct?

Yes, you did.

Now get a copy of your Explanation of Benefits from your HR department. It’s a document about 80-100 plus pages. You need to know exactly what YOUR policy says.

 

[JackieOnLine]

hello & welcome! you have come to the right place.

 

[C.Caldwell]

What is your current BMI?

Yes, you did.

Now get a copy of your Explanation of Benefits from your HR department. It’s a sure document about 80-100 plus pages. You need to know exactly what YOUR policy says.

Ok sure will,

 

[C.Caldwell]

Hi and welcome Chastiny! I see you posted an insurance question on a different thread. What procedure did you have previously and how would you like it to be revised?

Ok sure will,

I previously has Gastric Sleeve and appealing revision to DS. How do I ask for help with the appeal? Insurance denied revision due to no technical issues and denied peer to peer

Hi and welcome Chastiny! I see you posted an insurance question on a different thread. What procedure did you have previously and how would you like it to be revised?

 

[southernlady]

I previously has Gastric Sleeve and appealing revision to DS. How do I ask for help with the appeal? Insurance denied revision due to no technical issues and denied peer to peer

Read the pinned post at the top.
Then start a new thread in that board.
https://bariatricfacts.org/forums/insurance.28/