Bluegrass Family Health Denied My Gastric Sleeve Surgery in Kentucky

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I just don’t understand my gastric sleeve surgery denial by Bluegrass Family Health (BGFH). My BMI is 35.8. I have been diagnosed with Hypertension for the last 3 years and have been on 3 different medications for high blood pressure. I am also on
high cholesterol medication.

My glucose on my last lab was 118 and my A1C is 7.0 with an Average mean glucose of 150. Clearly I am a perfect candidate for the Gastric
Sleeve.

The reviewer denied my claim because he thought I should be on more Medication for high blood pressure. My surgeon is going to have a peer to peer with the medical Director but I don’t feel part of this process and I think I can help
Get this approved.

Has anyone had any experience with BGFH insurance denials? I work at the hospital that owns BGFH and my insurance is self funded.

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