Automatic Denial?

Scott W.
on 5/4/06 2:21 pm - Indianapolis, IN
Is it an automatic denial if I dont have 6 month dr. supervised? I am so impatient, I dont think I can wait another 6 months. I am going to see a dietician, so hopefully that helps. Thanks for your input. S.
SweetSherri
on 5/4/06 8:50 pm - Indianapolis, IN
Scott, All insurance companies don't require the 6 month dr. supervised dieting...so the answer to your question is 'no'. Also, it varies from insurance company to insurance company on what they will accept. Some require only a record of your weight, BP, and that you & your physician discussed weight loss incentives...where as others want a full description of what all your doctor was having you do, etc. Initially, I was on MPlan. My physician had it laid out what all I was to eat/don't eat, as well as the exercises I was to do...for 2.5 years, I did this & we discussed it at every office visit I had. MPlan decided that they didn't like the notes he kept. Then I switched to Anthem, and they didn't mind his note-taking at all. If you haven't already, contact your insurance and ask them if they have a packet of information on what their requirements are and ask them to send it to you if they do. If not, ask them to explain what the requirements are to you on the phone...and take good notes. Sherri
jellyin
on 5/4/06 8:56 pm - Indianapolis, IN
call your ins company and see....ask them what they require, and if your ins co appears to deny till the end, before they approve you then yeah i would try now to get approval...could be you will have what they want, where as some ins want the notes as sherri said, and they want detailed notes every monnth for 6 months and do not miss a month...
imonmyway
on 5/4/06 9:59 pm - Indianapolis, IN
Hello I am One of the ecxeptions, my insurance company only required a letter of necessity, I had called them ahead of time, before I had done anything and this is what she told me! Su I went to PCP and asked her for one, then I set up an appt with Dr. Nigh for my bariatrics consult ( Aug 10) between those two doctors and the pshyc eval I had a letter of necessity, and to my amazement I was approved and had a surgery date for Nove 1st, however I did have an infection on the 1st so I was sent home, but later had my surgery on the 29th of Nov. ! Just like the others said, call your ins. ask them what they require, keep notes, dates, times, who you talked to, fax #'s. etc, then you will have documentattion, I also had the fax # and when my doc's office faxed my info at 9:00, I called back at 12:30 to make sure it had been received, she said yes, dear and it has already been approved, good luck to you, WOW was I shocked, like I said ,I know it isn't this easy for everyone and boy how I wish that it was, I just want you and everyone else starting their journey's to not give up, get all of your ducks in a row, and go for it, it isn't always a rough ride, just keep your chin up!!! Hope this helps, keep up your spirits, soon I hope that you will have an answer and join us on the other side! DAWN in Indy
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