insurance denied surgery

jay1965
on 8/8/10 6:15 am - Lafayette, IN
Hello...I was recently denied surgery with Dr. Huse by my insurance carrier.  They stated it was due to not having 6 months of supervised medical weight loss with my pcp.    Has anyone else run into this issue and what did you have to do to meet "supervised medical weight loss" requirements?   I have seen my pcp for the last two years...every three months for blood work and "discussion" about meds and my weight.
I am appealing the decision. 
Thanks for any info you might share with me!
JAK
Terry B.
on 8/8/10 11:25 pm - Martinsville, IN

Have your PCP fill out a history of the last 6 months of weight loss supervision.  If you have been going in  regularly and being weighed and addressing your weight then you should be done.  If not then start now with your PCP.

 

I am only one, But still, I am one.  I cannot do everything, but still I can do something.  And because I cannot do everything, I will not refuse to do
the something that I can do. 
  
    Edward Everett Hale
  
                    Onederland 1/26/2010    
    
 

Melissa H.
on 8/9/10 2:08 am - Danville, IN
I agree. Ask your PCP to document your visits, etc and submit that. If that still doesn't work, then you will have no option but to do 6 months of supervised weight loss with your PCP. It's not the end of the world, just prolongs the process, but will make you healthier for the surgery in the long run if you are even able to drop a few pounds.
Surprise MIRACLE baby boy, Noah Andrew, born March 24, 2010

Check out my WLS blog at: www.melissawlsjourney.blogspot.com

jay1965
on 8/9/10 2:15 am - Lafayette, IN
Thank you for your info Melissa and Terry!  I hear what you're both saying...just frustrating that I have to wait another 6 or 7 months for approval.  I know some people have to submit 18 mths so I should stop complaining and get on with it. :)

Thanks again...Jay
indykitty
on 8/10/10 12:17 am
Jay, if that doesn't work there is a PCP there at St. V.'s in Carmel that I and my DH did our 6 month supervised diet with and they have a really good success rate of getting folks approved.
    
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