Denial

Well, I followed up with the ins. today and they e-mailed me to tell me that I have been denied due to lack of documentation. They want doccumentation of chart notes which I have already submitted. I called my pcp and basically that is the best they can give... he doesn't document well. Does anybody have any suggestions..I'm going to appeal. I have Indiana comprehensive and they usually aren't that hard to deal with I didn't think!!!! I feel like I'm just getting tired of always jumping thru hoops. My insurance suggested that I have 3- 6 months which I did. Should I seek out a dietician?

If you don't have doumnetation on the diet, so if you havent seen a dietiacian then yes, get with one. Lisa

denials suck and are so painful....appeal appeal ....whatever they denied you for address those issues in your appeal...those @&#^$ the very nerve of them....something to think about is your in for the fight of your life...

If the insurance company requires a medically supervised diet...this usually means the use of your physician and a registered dieticitian. If you are using a large bariatric center for your surgery, they usually have these programs in place and know what kind of records the insurnace company needs. I know that both St Francis and St V's have supervised diet programs. Good luck

I had to do an appeal also because of lack of documentation similar to yours. I had been seeing my family doc for a year for dieting and had been on Meridia which did not work. The office notes were incomplete so I asked my doc if she would write a personal letter of recomendation for the surgery saying I had tried for many years to diet unsuccessfully and that she felt the surgery was my best hope for wt loss. (and my doc isn't fond of the surery) She wrote the letter. I also had a letter written by a friend (that is a dr) that I worked with and dieted with for the last 8 years. besides a plea about how miserable I was. I also found an article on line that stated that for most morbidly obese people another supervised diet was basicaly pointless. I know how frustrating it is waiting to get approval so if I can help I'd be glad to. e-mail me and give me your address or fax number and I'd be glad to send you copies of what I sent in for my appeal to use as a guideline. I had my surgery January 17.2006. Tuesday will be my six week anniversary and I feel so much better already. I need to get on the scales tomorrow but I think Iv'e lost about 30 lbs.

Hi Jan, Thank you for the input I would appreciate it if I could see your letters as a guideline. I spoke w/ my ins. today and they had sent the wrong letter should have denied me 1st letter. I only have like 10 days to appeal. I am on the fence BIG TIME!!! Sounds like you are doing great! 30 lbs. in like no time you go girl!!!! My e-mail address is [email protected] or fax at my desk is 574-722-5124. Have a great evening! Kathy