Just another hoop to try to jump through

Ok so I am so sorry but I just have to vent to people who actually understand my pain.  I have completed all of the required appointments that my surgeon and insurance company had requested.  My paperwork has been sent to the insurance company awaiting approval since since about the 18th of september.  I called the insurance company again today and was told the medical advisor needs more weight management information.  So my insurance requires once a month doctor visits (or other approved appointments) which I completed.  I religiously went monthly just to specifically discuss weight management.  Now they think I may need to do three more months of another structured weight management program and go twice a month.  Three more months seems like forever as I have going through hoops since December to try to get everything done for surgery.  Let alone my copayments on all of these visits is draining my wallet.  The only good thing is that I completed a six week cognitive behavioral eating class that the medical advisor is going to review to see if that will be sufficient.  I really hope it is.  I am a stronge believer in everything happens for a reason but I just want to be able to have surgery.  AAAAHHHH!  Ok I feel much better :)

so they are changing the requirement for you? that makes NO sense. so sorry you are going through that. maybe speak w/ someone from Dr. Steele's office and see if they can clear this up for you. I will keep my fingers crossed. Insurance companies suck!

Thanks Nicole

I am sorry they changed up on you and I hope that it all works out for you. I too think that all things happen for a reason. I can see you have done all that was aksed. Good luck and keep positive thoughts in the end I think you will be the winner oh I mean Loser......

                                                                                                                   Julie

UGH...what a pain!  Hang in there!!

Thanks Everyone!  I am struggling with not calling the insurance company to find out what is going on.  I will wait until Wednesday and if I haven't heard anything I will call.  I am truly blessed to have found this board!!!!!!!

You have EHP, right?  I didn't have any issues with that, but I did the 6 month class that they offer at Bayview that is pretty much designed just to meet insurance requirements.

I did finally get a date, btw, but if I don't get under 370 before my pre-op appt they will cancel me.  You might want to check and see what they want you to weight before sugery, and if they are going to want you to see their new obesity med specialist before you can have surgery.  The reason they are making me do the extra stuff is my high BMI, so you may not run into the same issues.

Oh, also, EHP sets you up with a case manager for WLS.  You might want to give you a call and see if you can have your case manager's number and talk with him/her now (I don't think you have to be approved to do that - my case manager didn't even know that I had already been approved when I talked with her for the first time).  They know the requirements inside and out and should be able to help you make sure you do what is needed for approval.

Thanks Kelly-
I have spoke with Trista at EHP a couple of times.  I am going to try to call her tomorrow and see where we are with everything.  She is very nice.  I just want to know what exactly they want because I did in fact see my PCP for weight management once a month for 6 months.  If they want somthing more from my PCP I am sure you would give them what they need.  I feel like they just want you to get fed up with trying and give up so they don't have to pay for it.  Well not me I am going to fight until I get approved.  If need be I will do the 3 more months.  But you are right I am going to call Dr. Steele's office too and see if there are any other stipulations that I need to meet.  Nothing worse then thinking you are done only to have more to do.  Good Luck with everything I am sure you can get under 370 if you put your mind to it.  It seems like you want this bad enough to do it!!