Letter from MaineCare - Questions

So, I told everyone about my getting deferred. I finally got a letter today from MaineCare telling me about the extra paperwork they needed. Good thing I called them, right?? So, now they have the paperwork that they need I guess, it was faxed to them from Dr. Clough's on 12/8, so they have until 1/8 to give me an answer for approval or not. Unless of course they find something else they need. Anyways, my question is this... In the letter it stated that Northeast Surgery has asked MaineCare for approval of the Gastric Bypass. It then says , please ask the provider *****ferred you for this service to send us the following information. 43847 - Gastric bypass for obesity Please send medical history from Ms. Greenlaw's primary care physician documenting the type II diabetes mellitus and the high blood pressure. Also include the medication and dosage. Then it goes on to say - have the provider send us this information by 1/6/2007. If we do not receive this information by then, we will not approve the service. If MaineCare does not approve the service, it means we will not pay for it. So, asking you this - has anyone else gotten a letter like this, then got the info to MaineCare and got approved after?? I am just wondering why they need so much info. I believed that my PCP already sent history reports to the WLS program when I started this. Should I worry about them not approving, or is this just their way of getting more information/paper work? Thanks

Hi. I too have mainecare. I have type 2 diabetes, high chelstorol, amoung other problems. I weigh 404 pounds. However in May 2006, i weighed 476 pounds and then i started on a drug called Byetta. It is changing me so fast and fot the better. I still have very high A1C tests. I still have high chelsterol, which comes from the high sugars btw. But i have lost 72 pounds since may 2006. No change in what i eat. No extra exercise. Just that the drug makes you feell full after you eat breakfast and supper. Its a shot and you take it within 1 hour of eating your breakfast and supper meals. It has made my meals smaller than my thin friends. I used to be able to eat a whole large pizza and still be hungry. Now i eat 2 slices and feel so full I might barf. And a few times i ate too much and did barf. My new doctor is worried about my A1C, but after I talked to him for over 45 mionutes he thinks like me that its advantages of using the Byetta and having high sugars while losing over 10 pounds a month is worth a short term, less than 2 years, of high sugars as long as no infections or such pop up. Just an idea for you to see your doc about trying byetta before surgery. You cold start it before surgery and stop it once your surgery was complete if you wanted too. Just an idea. Good luck with mainecare. The beurcracy changes the rules every 45 days. In my Expereince. Especially with drug coverage.