Need Approval Help

BCBS of Tennessee has asked for more info about my husbands 6 month diet. DH has been seeing a nutrisionalist at his diabetic Dr. for a year. They have had him on a low carb type diet, with no results. Will this be enough for them. Will they come back and ask for something else or is this likely the only obstacle. Thanks, Kim

Kim, From what I have been through almost all of the insurance companies reguire about 5 yrs of diet info!! Now that doesn't mean it can't be a self-supervised diet for 3 years and maybe weigh****cher for a year then the 6 months with the nutritionist and 6 mos on the atkins diet or something. Just document everything that you can remember! I was in a support group with a girl that had the banding done and her ins. was bcbs. but that was a year ago and I am not sure of the particulars. Talk to the ins. people with your Dr. they will know what the requirements are and will be more than likely your greatest ally in this journey...Good Luck! Christy Dawn Light Live Beautiful!!!

Dear Kim, I know exactly what you and your husband been going through.. I have been on that low carb diet of 60 carbs. a day. I am a woman who's weight is 277 and I was passing out on the diet my doctor had put me on.. I have been on high blood pressure diets, diabetic diets and pills by doctors. I have excise for over three hours a day and not lost any wiegth.. I was told by a doctor that to save my life I would have to under go weight loss surgery.. I have been approved by my state insurance company only not to find a doctor that will accept TennCare Medcaid of Tennessee. I had a ovary problem that cause obesity and other problems to my health. My problem was caught late by a doctor atfer going to doctors atfer doctors.. Because of them I do not even have a percatage rate on having children.. But the only light they gave me was the surgery will greatly help your life and give you a better chance at having a child.. I wonder if anyone knows a Tennessee Surgeon that takes State Insurance TennCare Medcaid of Tennessee? I really feel for you and your husband.. It is a tough road for all of you. I think insurance companies are scare that once the poeple are healthy then they are not needed anymore.. Makes better sense to make the client happy so the can pay their insurance companies.. Hope you find a way, Tina

I don't know if this is any hel*****t but Dr. Wright at Vanderbilt in Nashville is an out of network provider. I called TennCare and they gave me his #! I have the medicaid too! I had to get an out of network approval and all that goes with it! I can give you the# to Dr. Wrights office. You will have to leave a message for Lisa Samuels. She will call you back and give you all of the info that you need!! 615-936-0438 fax # 615-343-7920 Here are some of the things TennCare requires *out of network ins referral *letter from your pcp referring you for gb evaluation, what your med. problems are, and if pcp has had you on any diets *5 years of medical records *specifically related to your obesity medical problem *documentation of physician, dietician, or group supervised diet/exercise attempts if any *psych evaluation Those are the things I had to have! My appt is Nov. 16th Good Luck, My thoughts and prayers are with ya'll! Christy Light