Tuesday, June 3, 2014

Revision Denied

"Insufficient evidence of serial nutritional compliance."

That's their reason.  They might as well have written "We are looking for a bullshit answer to tell you no."

I hardly ever get mad.  But right now, I'm PISSED.

My PA actually thinks this is great news though.  She thinks it's a small victory.  They didn't mention my BMI being too low, or having no comorbidities, and since it was not mentioned, they cannot change the reason later.  She thinks this is easy to dispute, because if I wasn't complying with the nutritional guidelines, I wouldn't have lost weight.  No one loses 110 pounds by eating cake, ice cream, and chips.  We all know this right... apparently BlueCross BlueShield of NC doesn't realize....

They will submit an appeal today with documentation of nutritional visits from the past as well as another letter from my PA documenting my typical eating habits.  If there is no news, my doctor will personally set up a peer to peer review, where the insurance company will have to send a representative to meet with my surgeon for an appeal meeting.

I hope my PA is right that this was actually good news.  It definitely does not currently feel good.

4 comments:

  1. awww that sucks, I hope that your PA is right and that you will get approval soon.

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  2. Hang in there! They are probably just hoping you would quit. So glad your surgeon's office is playing such an active role on your behalf. Good luck and chin-up, girl!

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  3. soory you were denied. I hear that happens a lot though, so it's nothing about you, that's just what insurance companies do. You got your PA on your side, so i'm sure your appeal with be sucessful.

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  4. Well, I'm with you, GLAD they think this is GOOD because it sure seems like a slap in the face. Ugh. I hope everything goes well, and you are doing all the right steps...hang in there!

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