Fighting ins co on weight loss attempts?
My insurance company wants 12 months of weigh ins before they'll even consider approving surgery.
I *can* wait that long but if I do I figure it'll put me having surgery in 2007. I'd like to have it done fall of next year.
My ins co is WV PEIA if that helps.
Should I even bother trying to get them to bend the rules? I'm not on the brink of death or anything but I more than qualify for surgery -- I need to lose about 200 lbs.
Hi Jennie M... Im Jennie T!
I have Accordia PEIA and Im fighting them too.
Think we could be twins?? 
My problem was not enough documentation from my (previous) PCP. I should be planning my surgery by the end of this year, if all goes well.
When I applied in June, I was under a Drs care for obesity but only had sporadic mentioning of my weight loss / monitoriing. So I was denied. I have moved on to another PCP who is doing a great job of documenting and I will apply again in November ( just to get a jump start ) and see if I will be accepted this time.
I never bothered fighting back with an appeal. I have dealt with Accordia and their appeal board before. They dont usually change their minds nor do they bend the rules.
Vita is a very nice woman to talk to at Accordia. She is the weight management specialist. Give her a call if you havent already. If you can get a copy of your previous years medical records, fax them to her and she will tell you how much more info they need. You may have something noted in your records already.
Dont forget to go to the seminar ( I went to Dr Shin's) They are very informative also.
Good luck,
Jen
My problem was not enough documentation from my (previous) PCP. I should be planning my surgery by the end of this year, if all goes well.
When I applied in June, I was under a Drs care for obesity but only had sporadic mentioning of my weight loss / monitoriing. So I was denied. I have moved on to another PCP who is doing a great job of documenting and I will apply again in November ( just to get a jump start ) and see if I will be accepted this time.
I never bothered fighting back with an appeal. I have dealt with Accordia and their appeal board before. They dont usually change their minds nor do they bend the rules.
Vita is a very nice woman to talk to at Accordia. She is the weight management specialist. Give her a call if you havent already. If you can get a copy of your previous years medical records, fax them to her and she will tell you how much more info they need. You may have something noted in your records already.
Dont forget to go to the seminar ( I went to Dr Shin's) They are very informative also.
Good luck,
Jen Most Active
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