°`°º¤ø¤º°`° Encore °`°º¤ø¤º°`°

Hi all, Newbie here to the boards but not to my quest! I'm seeking some advise this time around however as about 6 yrs. ago I was denied three times by my health provider due to MY ignorance! Older for sure and a bit shady on the wiser side, nevertheless, it is imperative that I obtain surgery this time around. First and foremost; I seem to be having a difficult time simply finding/figuring out just who is my insurance provider, let alone obtaining an address to submit letters to. I am on both, Medicare & Medicaid and have full benefits for both... (Yessss, I have dialed endless numbers to find out who is whom ~ all I've gotten is dizzy!) LOL! Secondly; Just how does one successfully "list" their dietary/weight reductions attempts when a significant number of them have been "unsupervised professionally"? Any and all suggestions, support and guidance in these two realms is most appreciated! Terri ^i^

Hi Terri, I know there are quite a few out there that take Medicare & Medicaid. I have Medicare only & had my surgery through CORI. Dr. Schuhknecht is my Dr. & does take both of those insurances. As far as getting approved, I didn't have too hard a time. The easy part for me was obtaining the "weight loss history". I think you only need one year now but I needed more than that when I started out. Even though I didn't go into the Drs. office every month to be weighed in, he recorded every time that I saw him (2-3 times a year) that I had tried & failed at weight loss and would record his suggestions to me. I also listed all of the diets that I had tried & what the results were each time (ie how much I lost & then gained back) That was all that was needed. It sounds like the need a lot more but in the long run, it isn't all that hard. As for as finding your providor. Let the Drs office do that for you. Dr. S. office will tell you what you need & will take care of the insurance for you. Email me if I can help answer other questions. Peggy

Terri, I also have Medicare and Medicaid. I know that medicare requires you to use a "bariatric center of excellence" from their list on their web-site they only list MMPC (Spectrum) in Grand Rapids, however Hurley in Flint is now on the list as well. I know other centers are working toward their accrdidation (sp?). I know for me, I went to Hurley, and I have been providing with all the information they need to submit for pre-approval. They are handling it all for me, I do not have anything to send in. I should have all my stuff in soon and hopefully next week they will be sending in for approval. Here is a link you might find helpful. You may have to coppy and paste the url. Good Luck this time around. http://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=160 Shawn M.