The Battle has begun!

Traci Baker
on 4/10/06 11:22 am
So my paperwork was first sent to my insurance company back on March 14, 2006. I gave it two weeks and called on March 28, 2006. To my surprise (not really) they did not have any paperwork! At that point I asked for a name, phone number with extension, address and fax number of a contact person so the paperwork would reach the correct department. When I called on April 4, 2006 (one week later) and again the customer service rep stated there was no information on file. The CSR then checked while I was on the phone and said oh wait it just happens to be sitting in my IN box. Yep makes me wonder just how long? She explained that this type of paperwork had to be forwarded to the ICM, Individualized Care Managment group for review and determination. I called ICM today and after being told to call 3 different numbers I finally found someone who let me know that I was denied. Same response many people are getting " Need evidence of the patient participating in a physician-directed weight loss program for 18 consecutive months with bi-weekly weighing, treatment and discussion. I asked to have the letter faxed to me so I could get the appeal letter ready which I actually wrote a few months ago in anticipation that this would happen! Now I will forward my appeal letter by the end of this week and contact my doctor to see about starting a program so I cover all basis. For all of us out there that have to complete an 18 month program after battling our weight our entire lives, I pray that things will change in July when the law goes into effect regarding the 6 months verses 18 months of physican directed weight loss programs! The battle has begun!!
jellyin
on 4/10/06 12:22 pm - Indianapolis, IN
18 months, 6 months...with an obese person it does not matter and losing 10% of your excess weight is crazy if you are 150 pounds over weight and lose 15 pounds your not even gonna notice it let alone anyone else..this law you spoke of is news to me..though there should be a law any obese person that wants this surgery should have it..in 18 months they will have an iron clad exclusion...
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