LOOKING FOR A NEW DR NEAR ST. HELENS
My PCP in Portland is not supportive of WLS and I need to find a new dr. I am now living and working in St. Helens so hoping to find someone here that anyone can recommend.
Also, I was so close to being approved by insurance and then when the final papers were submitted, it came back denied and want me to do 5 things:
1) 6 month weight loss program within the last 2 year with physician chart notes documening partcipation in a dietary program which consists of a very low calorie diet and includes monthly weigh-ins and nutritional analysis;
2) at least monthy clinical encounters with a healthcare professional who does not perform WLS;
3) documentation of a regimen of increased activity and exercise (how do I document that?)
4) participation in a behavioral modification program supervised by a qualified professional to reinforce dietary terapy and increased physical activity; and
5) documentation of a weight loss management history that includes any pharmacotherapy with physician prescribed weight loss drugs.......
I called the insurance company and they were very rude on the phone and gave no further explanation. I did do 6 months of Weigh****chers within the last 2 years, but I don't have my book they write in. Has anyone had any success getting any documentation from Weigh****chers in the past?
I am bummed. I already did everything and even met with the surgeon and thought everything was ready. Supposed when Legacy called the insurance company they were told I had no requirements to meet....and of course, now they say they never said that. I am tempted to just self-pay they surgery now and not go through all the rest of this crap. Just curious if anyone else has had this same situation and how you resolved it. I thought just with the 6 months of a program it would be good enough, but oh no.....
That's why I am also looking for a new dr. to see what they might recommend. Thanks for any help you can suggest!
Sherri
linda lallonde OHSU clinic SH.
good luck
tee
JIB, 1986
Reversal/Revision 2004
"Everything that elevates an individual above the herd and intimidates the neighbour is henceforth called evil; and the fair, modest, submissive and conforming mentality, the mediocrity of desires attains moral designations and honors"
- Nietzsche