Dr. says. is it true
Dr. Singh tells me today,amongst some other disturbing things, that Blue Shield of North Eastern NY(community Blue) wants 6mo.-2years of diet history. I chose this company because I thought they were good about WLS. Any one have experience w/ BS of NENY and or Dr. Singh. I have been at this for over 2 years and I am getting really frustrated. Thanks
Tami
(deactivated member)
on 8/25/05 10:14 pm - MT
on 8/25/05 10:14 pm - MT
Tami,
Thought I have not used your Dr or have your Ins Comp I know how it feels to have to do that 6 month weight loss program. I am sorry that you are having such a hard time getting through this! ~Hugs~ Please do not give up, do what you have to do and get through it! I know it sucks but do not give up on what you really want. My cuz went through all of the BS as well and she was about 2 years to get her surgery also and now she is so happy being 1 1/2 years out! For some reason hun it will come through when the time is right, please believe in that! I know you don't want to hear that right now and I can understand being so frustrated but hang in there. ~Hugs~
I hope you have a great day hun and also a awesome weekend 
Debra P 
Debra P 
Tami, 
I have Blue Shield Of NENY / Community Blue . I spoke with them on the phone first just to see if they would cover it and they said as long as it was medically necessary . I then called Dr. Lirio's office ( my surgeon) and asked what was needed from me and they said at least 6 months of diet history with some of that history being medically supervised . What I did is I went back the prior 5 years of my diet history and wrote down the diet , how long I was on that diet and how much weight I had lost and regained after that particular diet . I know I did not need the 5 years but I figured I was going to cover all my bases so they would'nt have any reason to deny me . I then went to my PCP and of course she had medically supervised my diets at some point in time and just told her what she needed to add in my LETTER OF MEDICAL NECESSITY .
Your PCP needs to document in that letter that he/she supervised such and such a diet for at least a period of six months . It can be several different diets adding up to a period of six months or one diet for six months .Your pcp needs to be specific though as mine was'nt specific enough so I eventully wrote my LETTER OF MEDICAL NECESSITY and she typed it up on her own letter head and signed it .
Oh and you also need a referral from your PCP.
My surgeons office won't even schedule a consult until they have that letter and know that it is good enough to send in to the insurance Co.for approval.
I have not had my first consult with him yet but am scheduled for Sept. 22,2005 . So I also have not had the paper work sent in to ins. but as long as everything goes well my surgeons office said they don't think they will deny me .
There are people out there that have gotten the surgery and their approval from BS of NENY/ Comm. Blue and hopefully they will post some answers for you .
If you would like you can email me if you have any further questions or just want to chat. I would be glad to help you any way I can .
I hope this helps !
Take care and best of luck to you!
Carol
I have Blue Shield Of NENY / Community Blue . I spoke with them on the phone first just to see if they would cover it and they said as long as it was medically necessary . I then called Dr. Lirio's office ( my surgeon) and asked what was needed from me and they said at least 6 months of diet history with some of that history being medically supervised . What I did is I went back the prior 5 years of my diet history and wrote down the diet , how long I was on that diet and how much weight I had lost and regained after that particular diet . I know I did not need the 5 years but I figured I was going to cover all my bases so they would'nt have any reason to deny me . I then went to my PCP and of course she had medically supervised my diets at some point in time and just told her what she needed to add in my LETTER OF MEDICAL NECESSITY .
Your PCP needs to document in that letter that he/she supervised such and such a diet for at least a period of six months . It can be several different diets adding up to a period of six months or one diet for six months .Your pcp needs to be specific though as mine was'nt specific enough so I eventully wrote my LETTER OF MEDICAL NECESSITY and she typed it up on her own letter head and signed it .
Oh and you also need a referral from your PCP.
My surgeons office won't even schedule a consult until they have that letter and know that it is good enough to send in to the insurance Co.for approval.
I have not had my first consult with him yet but am scheduled for Sept. 22,2005 . So I also have not had the paper work sent in to ins. but as long as everything goes well my surgeons office said they don't think they will deny me .
There are people out there that have gotten the surgery and their approval from BS of NENY/ Comm. Blue and hopefully they will post some answers for you .
If you would like you can email me if you have any further questions or just want to chat. I would be glad to help you any way I can .
I hope this helps !
Take care and best of luck to you!
Carol Tami,
I am a patient of Dr. Singhs and I had a long wait from the start of this to the surgery day. I feel your pain. I would be willing to chat with you on the phone if you want.
I go to the St. Peters meetings on Tuesday eves.
Please feel free to email your # and a good time to call if you want.
HUGS
Mary
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