Cross-post: And 1st time posting. Need help!

Hi! This is my first post. I am in the stage of gathering all the info for the pre-qualification letter that the surgeon's office will be sending to the insurance company. They want weight-loss documentation from the past year. I am trying to get together any weight-loss attempt history documantation that I can. I don't know if I'm going about this correctly. Maybe someone can tell me? I just want to make sure I get it right and don't spin my wheels w/ unnecessary stuff. I have: - Photos of me going back to age 8 at dramatically different weights - 2 weigh****chers booklets from the last year w/ weight staring at 209, ending at 230 (!) - Cancelled checks from weigh****chers going back to 2002 (unfortunately I didn't save the stamped booklets) - A cancelled check from a nutritionist/dietician from 2002 - I may be able to get documentation from a Zone diet delivery company that I used for about 6 months last year. They went out of business since then so I may just have the credit card records... - Would a letter from the muscular therapist ! saw for weight-related back problems be helpful? - Also, My PCP is having her nurse write the referral letter this week. I'm sure she would be open to a template or letter that would word things in a helpful way if anyone has that? Any help in this area would be greatly appreciated. I would love to get approved right out of the box. BTW, my BMI is about 41 right now. Thank you!!!

Hi D and Welcome to the NY Board~~~ Below is a link to starting your journey, from right here at AMOS. You can do a lot of research by going to the top of this page and click on a topic of interest, or just go the WLS home. Sounds like you have lots of documentation and are doing your research. Letters from everyone that you saw related to problems caused by being overweight, would be helpful. http://www.obesityhelp.com/morbidobesity/WLSjourney.html Also, this is the link to all the insurance co here at AMOS~~~ http://www.obesityhelp.com/morbidobesity/bariatric+surgery+insurers+in+new+york.html You will find a great group of people here who will be able to help you with any of your questions or concerns. Please post again and let us know how your journey is going!! Good Luck. Alice

Well I think for the most part it depends on what your insurance company requries - call them to find out, or check to see if they have info on the web. I have Aetna and I had to provide documentation that I have struggled with morbid obesity for 5 years. The only documentation I provided was a letter from my doctor with the following information: 2/97 - 3/97 Redux (don't recall exact weight starting out - probably around 200 lbs, however weight must have been significant to qualify for Redux) 9/4/98 - Dr's office visit - 181 lbs 1/00 - began Weigh****chers at 205 lbs. 3/31/00 - Dr's office visit - 171 lbs (did not maintain weight loss) 1/01 - began Weigh****chers at 209 lbs 4/13/01 - Dr's office visit - 181 lbs 12/1/01 - Dr's office visit - 167 lbs (did not maintain weight loss) 9/18/02 - Dr's office visit - 187 lbs 5/03 - began Curves low carb diet and exercise regimen - 213 lbs 11/12/03 - Dr's office visit - 183 lbs (did not maintain weight loss) 2/18/04 - Dr's office visit - 212 lbs Some of this was in my doctor's notes and some of the info I provided my doctor with but all that went to the insurance company was this in the body of a letter stating the necessity for bariatric surgery on my doctor's letter head and signed by my doctor. My MBI at the time of surgery was about 41 too - I think 41.5 to be exact. I hope some of this is helpfull! God bless you and keep you, ~Andrea

Hi D, I included many of the things you listed in the package I gave my surgeon's office to submit to the insurance. I don't know for sure that it helped, but I figured it couldn't hurt. The more documentation the better. I would say the letter from your muscular therapist would be helpful. I have a template for the letter for your PCP at home, I will send it to you later. One more thought, have you check your insurance company's policy on weight loss surgery. I have Aetna, and they had additional criteria that you had to meet on top of that for the gastric bypass surgery before they would approve you for the lap-band surgery. Best of luck with everything. Mary

Mary - Thanks for the reply. That letter would be great, I'd really appreciate it. D