Insurance reject your initial submission? I'm trying to prepare for any outcome.
I am still in the process of getting approved with my insurance. My final appt with my doctor is to be scheduled and then my package will be sent to my insurance (TriCare) for approval. TriCare generally has a response in about 1-3 weeks, but I am now nervous on whether or not I will get approved.
My question has a few layers:
1. how many of you were denied by your insurance company the first time for WLS?
2. do they give any reasons for denial?
3. how long did it take to finally get approved?
4. is there a trend (or has anyone noticed) that one WLS gets denied/approved more than any other?
I haven't been denied, but I am just nervous/excited about the entire process and want to be prepared.
I appreciate all of your responses and insights. Thank you.
Insurance companies love turning people down because they know most of us won't fight back, so don't let it come as a shock if they do deny you. Just be prepared to fight back.
I did get approved, 2 days before my scheduled surgery, imagine how much of a mental case I was
TriCare is, unfortunately, its very own special kind of beast. For example, they are, as far as I know, the ONLY insurance that will not cover the Duodenal Switch procedure. Pretty much any other company who says they will not cover it will approve it on appeals since there is overwhelming evidence that it is an exceptional procedure, and even Medicare covers it, but TriCare just plays by their own rules.
Hopefully, it won't matter because you will get approved the first time around!
Insurance reject your initial submission? I'm trying to prepare for any outcome.
