STRESS OUT AM EATING
NOW I WAS denied WLS so waiting on peer to peer decision now I spoke to someone from insurance company I never had a supervise diet, I think that's the problem Dam what can i do i been so stress i just got of my diet, started eating more they only ask for my 5 years weight history now they talking about 6 month supervise diet that crazy. anyone on here who was denied and still won they appeal with out 6 month diet. they told me i was denied cause it was not medically necessary.
A six month supervised diet is completely normal and is to be expected by most insurance companies.. Some insurances waive the supervised diet if you have a BMI of 50 or greater. But really, there are so many people doing their diet, no questions asked. Why should you be the only one who gets to skip it? It's best to just do what the insurance requires because it's their policy...for everyone. It still takes months of lab work, clinical tests, psych evals, sleep study's, ekgs, pulmonary function tests, bariatric classes, etc...anyway. By the time you complete those, you'll be half way done or more.
What I've learned in this process...you can't just wake up and say, "oh, I think I'll have WLS next month.". No way...it takes months! There are so many steps and hurdles. This 6 month supervised diet, least of your worries.
What I've learned in this process...you can't just wake up and say, "oh, I think I'll have WLS next month.". No way...it takes months! There are so many steps and hurdles. This 6 month supervised diet, least of your worries.
pedirn06
on 11/18/11 2:29 pm
on 11/18/11 2:29 pm
VSG on 01/26/12
IMO.......Seems your MD office staff who deals with insurance would have been more knowledgeable about your insurance requirements. Oftentimes, if insurance is filed without all of necessary documentation(sometimes insurance companies will not illude to ALL of their requirements upfront - that is why is is so important to work with someone very knowledgeable in dealing with bariatric claims), their denial will be "not medically necessary". That is because basically, you have not qualified that it is "medically necessary". Probably you will just need to complete the 6 month supervised diet, psych eval, NUT consult, etc. BTW, what insurance do you have?