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Update: I am now approved. The new sleep study and correct hypertension information did the job. I'm scheduled for July 31st. Thank you all for your help and encouragement.

The new sleep doctor wouldn't do a new study. But finally Dr. Boyce's office is doing a new sleep study! I pick in up in the morning and return it on Friday. Praise God. In the mean time, I received this big big packet from the insurance regarding my fair hearing. It says in it repeatedly that...

Seeing sleep doctor on Monday

I do have a sleep doctor and I'm scheduling a new study first thing in the morning

Weight loss surgery is medically necessary for me. I meet the requirements for approval for the reason that follow: 1. My BMI is more than 35. Documentation provided. 2. A BMI of 35 requires at least 1 comorbid disease. I have 5 of the accepted conditions as follows: A. Hypertension not well...

So one the most recent denial letters said I needed the copy if my sleep study results and that this results had to show an AHI reading greater than 30. My study is more that 2 years old and I'm much worse with the AHI readings on my machine showing sometimes 67 or more. I knew my old study...

I'm sorry for the novel, ya'll. I'm having a bad day. I don't feel well at all and I'm frustrated to death. Thank you all for listening

@writegirl I'm at the end of my rope with these people. My insurance sent specific numbers that my apnea has to meet. And asked for a copy of my study. I had my sleep medicine doctor send that to the Pre-d coordinater at Boyce's office. "The insurance person" I knew my numbers on this study did...

@writegirl I'm so sorry you've had to deal with this. They first told me they didn't accept my secondary. That was in August of 2015. That following January they began taking it. They didn't inform me until I had waited until July so that I could change insurance to what they did accept. Blue...

Diana, that's a brilliant idea! Thank you! Southernlady is right. They have their play book and seem stunned when there's a curve ball. The lady who got me approved initially was an exercise person, filling in for the insurance person who was on vacation. She's aggressive. The actual insurance...

I've tried to get an EOC when I first started this, based on things I've read here. It's like pulling teeth. But I'll get back on that come Monday morning.

I have United HealthCare Community Plan as my secondary insurance. UHC is my state's Medicaid. My primary excludes all bariatric surgery. In August 2015 I started my journey by attending a seminar. The office of my surgeon suggested switching from Blue Care to United HealthCare as they said it...

Just thought I'd let yall know that I tweaked my letter a bit and PCP signed it without an issue. I'm taking her article on my last supervised diet visit at the end of this month. Then hopefully they'll submit to insurance super quickly and all will go well and I'll be on track to surgery super...

Today's response was: you can't have that information unless your doctor has already submitted the request. I'll call again. I'm dedicated to this. I've worked to hard to let 5 years ago effect what I'm living with today

I spoke with Southernlady yesterday. The reason I included the Sjogren's is because it's attack on the joints, which is my only symptom right now, praise God, is considered musculoskeletal, which is one of their comorbidities. If it's better exclude that rather than trying to explain that to...

* deleted double posted thread

Regarding Jennifer L. Holt Date of Birth: -1980 referral for Biliopancreatic Diversion with Duodenal Switch Bariatric Surgery Dear Sirs, I am recommending and clearing Jennifer Holt for evaluation and consideration for Biliopancreatic Diversion with Duodenal Switch Surgery procedure as it is...

My insurance is BlueCare TennCare, Tennessee's medicaid. Actually it's my secondary. My primary excludes. Next week is my 5th supervised diet visit with my PCP. I've completed everything else. I meet all of their criteria except the need for the 5 year weight history showing morbid obesity. I...

I read this yesterday and found it heartbreaking. I really feel bad for people on the yo-yo. I am a firm believer in the body's preference for a certain weight in both directions. I'm a lightweight. 2 more monthly visits to my primary care for the monthly supervised dieting. My body likes to be...

My favorite thread so far!