just getting started

Hello everyone. I am a 36 yr.old with a BMI of 56. I have been over weight since I was 5 yr. I have justed started my journey to get wls. I am going through OSU and have caresource. I would love any advise on how to get this approved...example(how to write a letter to the insurance company and other documents i should send to help with the process) and so on. My PCP really don't act like she has a clue on what she is doing as far as recomending  someone for wls she has never done it, she keeps telling me to eat an apple if you feel hungry, boy if it where only that easy. I have lower back pain and bad knees and now my hip is starting to hurt and I have agoraphobia. Every time I tell her that something is hurting she says "and why do you think that is" i always say my weight and she says then you need to eat right..."NO" you think. So I would really love any advise from those who have been there and succeeded... Thanks                          Cindy

Cindy, I really like Dr. Needleman / Dr. Mikami and the program there at OSU.  My surgery was Dec. 2005 and have had very few problems.  Gotta drink, get the protein in and WALK / bike/ jog / exercise.  Get your PCP on board or find a new PCP that will give you a good referral for WLS. My knees don't hurt any more, I don't take blood pressure meds any more, I don't take blood sugar meds any more, and my cholesterol is 163 now.  My lap r n y helped to eliminate all these problems. Good Luck. No

Yea i think i better find another PCP. I went to my DR. today and she said she has never done this before...she said she don't know what to do as far as writing a letter to my insurance...so does anyone know a Dr. that takes caresource and has helped someone get approved for wls in the Columbus area. I am happy to here that things have went well for you...i can't wait until the day my legs, knees and hips don't hurt anymore.                     Thanks, Cindy

Ok everyone my dad is going to try and get a loan for me I can't i have a large school loan. I am having more hip and lower back pain everyday....i don't think I can wait 9 mths to a yr. just  to see if i can get aproved...i have waited to long as it is....i'm so scared that i will be in a wheel chair by next year....wish me luck                             Cindy

Cindy, as far as the letters go, I know I found sample letters in the insurance board but I got there from the DS board, so I dont know if  you can get there just going to the Insurance forum. I would ask your questions there, and click on the FAQ section too. It may help your PCP know what is really going on and how they could help. I printed it up for my PCP, just so he could also know I had been doing my homework...Insurance is different for everyone. I didnt need the 6 months of documented weight loss efforts that some ins require. Just 5 yrs of documented  obesity. Co-morbidity will help get the approval....Let me see if I can find the link to those letters for you.....Okay, so I looked for 20 minutes and couldnt find it, but I posted on the DS board to see if anyone else could find it for me. If they do, I will send it on to you....You may want to check out the DS board, it is such a great surgery, like the Cadillac of WLS. It has a much lower chance of weight regain and is great for a normal eating pattern when you are a few months out.....Stephanie

Okay, one of my friends on the DS board sent me the link to the samply insurance letters.....here it is....

 

Post Date: 7/31/07 10:43 am
Is this the page?  The links to the sample letters is toward the bottom.

http://www.obesityhelp.com/content/choice.html 

You can thank Redhaired for the info! It really helped me know what needed to be said and how to say it properly, this is from the experts!! Stephanie

Thanks soooo much Stephanie. I don't know to much about the DS I guees I will have to check into it.              Cindy

Cindy, I know you said you wanted to get your surgery at OSU, but you might also want to look into the Doc's in Dayton if you decide to look into the DS. I was going the RNY route before I did much reading on the DS and is just seems like the perfect fit for me. It is harder to find a surgeon, but I know of at least 3 in Dayton/ Miamisburg/Kettering area and the one I am going to see is in Bowling Green, but that would be a longer trip for you than Dayton. Feel free to PM me if you have any other questions, I have a ton of info that I love to share with others....Stephanie