tenncare medicaid

bigkat1977
on 12/2/08 5:24 am - lawrenceburg, TN

my name is kathryn. my sister and i want to have the gastric bypass surgery, we are starting the process of all the paperwork. we are having a hard time with the 5 years of documented weight. does anyone know if it needs to be consequtive years?? Does any one have advice for us. we would appreciate any help yall can give us on getting this crap done. its really frustrating too. HELP us pretty please. thanks..

SCOTT O.
on 12/2/08 6:23 am - Nashville, TN

RNY on 12/18/07

Congrats on the start of your journey! Talk to your PCP. If you have seen your PCP at all in the last 5 years, they should have some type of weight documentation.

My wife would not weigh in when she went to our PCP. So she was able to document her weight with pictures over the previous years.

Good Luck! If you need anything, jump right in and ask!

Santa Scott

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Bob L.
on 12/2/08 6:47 am - Clarksville, TN

RNY on 04/01/08

Your Primary Care or any specialist you've had would keep a record of each time they weighed you. Mine simply wrote them on their letter head dates and weights. I also had no formal weight loss documentation as: weigh****chers, nutrasystems etc. so I simply wrote out all the over the counter or prescription diets I'd been on with starting weight and ending weight duration of time I stuck it out and reason I quit! My insurance excepted it each has their own requirements. Good luck! C'ya Bob

bigkat1977
on 12/2/08 9:47 pm - lawrenceburg, TN

Thank you so much for letting me know, I hope my sister and me can make the criteria. i appreciate you responding and sharing with me, god bless you and have a happy holiday.

bigkat1977
on 12/2/08 9:50 pm - lawrenceburg, TN

thank you so much. it feel good knowing that people are here to help one another when needed. i appreciate your advice, have a wonderful holiday......kathryn

(deactivated member)
on 12/2/08 9:29 am - Sevierville, TN

RNY on 02/05/09

If you have TennCare you will have to provide documentation that you have been obese for 5 years. It requires not just a letter but actual notes from your medical chart. You will need a chart note from each year of 5 consecutive years. It will need to include your weight and blood pressure on each note. It doesn't matter if you were being seen for actual weight issues. Just as long as you saw a doctor each year for 5 years and were weighed in and your blood pressure was recorded. This is specific to TennCare. You will also need to complete a 6 month medically supervised diet. I would start on that immediately with your PCP if you are serious about surgery. Whoever you choose to be your surgeon will have all the information you need. Finding a surgeon who takes TennCare is not always easy. Good luck to you. Please feel free to PM me if you need anymore information.
Blessings,
Karen

bigkat1977
on 12/2/08 9:44 pm - lawrenceburg, TN

Thank you so much for your information. my sister and i have already been doing the diet plan with the dr. for about 8 months. she's been wanting us to have the surgery for a while so she put us on a plan just in case we wanted to have the surgery, I'm glad she did so thats out of the way. i just hope and pray that everything goes well because I want to be healthy and happy for my kids. they are 13, 10, 6, and 3. I will keep you posted on what we find out. god bless you.
Kathryn

(deactivated member)
on 12/3/08 12:29 am - Sevierville, TN

RNY on 02/05/09

You are very welcome. Please let me know if I can be of help in any way.
Blessings,
Karen

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