Denied

I was prepared to be denied but it didn't make it any easier to hear. I'm waiting for the letter so I can start the appeal process. The surgeon's office said my pcp did't document enough about my weightloss attempts or what diet ex. program etc. I was following in her progress notes in the past 6 months (I sent them 10 months). There was to much regarding my other medical problems! Imagine that do you supose that if I didn't weigh over 300lbs that maybe the other medical problems wouldn't exist? What my dr isn't supose to address those issues along with documenting my weightloss? I doubt they even went through everything because they kept asking for things they already had and of course nobody would talk directly to me I would call get a voice mail they would call the surgeon's office they would call me! I won't give up I know this is the only chance for me for me to live a long and healthy life. I can do this. Cheryl

I'm sorry you were denied. You should appeal it. I have heard of alot of people who had to appeal and won. Linda Vicory

Cheryl, Im so sorry to hear this bad new. im glad u arent giving up and will continue to fight the insurance company. I know my insurance made me have 18 months of RECENT dieting/ wt loss with monthly wts from my drs office. I even sent them records from my gym. You might call and ask your insurance company what they require for approval and then u can make sure u get that much from you dr. It makes things much simpler. If I can help you in any way feel free to ask. Mariah

Cheryl: I can totally relate to you! My PCP didn't document everything either. I was denied. I had to start from scratch with the supervised weight loss attempts with a new PCP. Keep the faith. It will happen!! Hugs Claudette

Cheryl, Be sure you have a good heart to heart with your pcp about this and ask them to contact the insurance company to see exactly what they require. I was originally denied (appealed and denied again) through MPlan because they "didn't like the way the doctor kept his notes". When I asked for particulars, they wouldn't (or couldn't) list any. When I asked the doctor to contact them, he said "my note taking is just fine". End of subject. I had 2.5 yrs on his diet plan that they refused and wanted me to start all over for another 18 months with the same pcp without any advise on what needed improved. I switched to Anthem the next January. They accepted the doctors notes as is. I did also later switch doctors (he was a jerk!). If your pcp were to contact the insurance, it may be that you just need a very detailed letter from their office. Best wishes! Sherri

gggggggrrrrrrrrrrrrrrrrrrrrrrrrrrrrr....................contact gary if need be......who is your ins? you know your dr wrote what he knew to write, chances are no matter what was written they would have picked it apart....they want u to go away...appeal appeal and appeal some more..this is the fight for your life

I wrote someone else. Obesity is considered a disease and if u jump through all your insurance hoops and keep all documentation they cannot deny u. Get as many of your doctors approvals as u can including gynocologist. Weight effects that part of you too. If need be use the attny services because Insurance cannot disapprove a disease it is not cosmetic surgery.