MEDICAL MUTUAL OF OHIO

Is there anyone out there who has MEDICAL MUTUAL OF OHIO & know what there requirements are for LAP RNY, I changed to MMO the beginning of this year, because other employer ins had an exclusion. I did a 3 1/2 month Phy/Nutr for weight loss/control last year. Would that be enough for MMO or do they want 6 months?

As you probably know.....Medical Mutual requirements can be different from employer to employer, but I will tell you what they told me. 1) Five years of weight history documented on doctor's notes. They can be different doctors (primary care, gynecologist, endrocrinologist, etc), but they want to see that you have been morbidly obese for five years. 2) Psych visit with an MMPI test. 3) Six consecutive month doctor supervised diet with notes on kind of diet, exercise, and reason why if you are not losing weight. I submitted all of this and then they came up with a requirement that was never listed -- a nutritional assessment. My caseworker, Latonya, at St. Vincent's in Cleveland took care of that for me. Good luck!

Thanks Winner Girl!! I have already had my 2 Psych visit with an MMPI Test, my problem is that My orginal PCP left the practice & went o Cleveland VA, to do outpt, she gave my the okay (thumbs up!!), she was the one *****quested the Supervised Diet w/the nutritionalist last year. Now I have a new PCP, she is in my corner with me having WLS, I wonder if she could use my old PCP notes from the last 5 prevs years, because old PCP even referred me to Physicians Weight Loss about 2 1/2 yrs ago!! I have also had my Surg/Consult, & My nutritional assessment. Last year I was also enrolled in a low impact aurobics class!!, Well I will have to get on this tomorrow!!! THANKS WINNER GIRL!!

*6 month weight loss attempt with doctor Listing all the ways you the attempeted 1) Diet, 2) Excercise, and 3) Behavior Modification. Your doctor's notes to the insurance company after the 6 months should mention those 3 critieria. I know this because they intially denied me naming the above "inadaquate proof of 6 month diet/excercise/beh. mod.". . ****Also, this 6 month diet has to be within 12 months of your surgery. ***** * 5 year weight history *Pshy evaluation *Extensive labs required by both Surgeon and MMO This is a very long process. I began my 6 month the end of March and just had my surgery Feb 27. In my experience they don't like to cover this procedure and they will test your patients to prove the point. Good Luck to you.

Thanks Amber for the info, will get started on everything 1st thing tomorrow morning!! Congrats on your surgery!!!!!!!

I also have Medical Mutual I had to have: 5 year medical history 6 month supervised diet Psyc evaluation Family physician referral Surgeon referral I sent in my file and got approval the first time in under a week. Two additional things I think could have possibly helped was I sent in a personal letter (in which I detailed my weight pattern and I listed my family history which is bad for health conditions) and also I got on the Medical Mutual website and completed their on-line health assessment and each health risk was high because I needed to lose weight so I printed that off their website and sent that with my file and highlighted the lose weight part on each page. I don't know if these two additonal items helped or not but I got approved pretty quick. My only co-morbities is a back problem and boarderline high blood pressure.

Thank you soooo much for your info, thank you for that last tid-bit, I will go to the Medical Mutual Website, this evening when I get home from work & look for the assessment!!!!! I need all the amo I can get!!!! THANKS A BUNCH!!!!!