DENIAL

Well, I received news today from Neighborhood Health that my request for surgery has been denied. I was told I have the right to appeal but it will be denied again without 6 months of a doctor supervised weight program with exercise and nutrition. Who has the money to spend for a diet doctor, exercise and nutritionist? I know one thing -- I have spent over $1,500 out of pocket since May when I first began this procedure -- only now to be told that my surgery is not approved! That is $1,500 that I surely could not afford to lose but have -- in addition, I am now being billed from the hospital for tests that the ins. will not cover! I am so upset --- I have been crying all morning. I feel like such a loser -- once again!

I'm so sorry for you. Is it possible for you to gather old medical records that prove you have tried and failed dieting in the past? I had records from a dietitican and a doctor who prescribed Meridia to me. Good luck BTW I'm in Miami--contact [email protected]

Thank you, Julie. I have sent NHP everything -- prescription receipts for Phen-Fen, Xenical, Phentermine, etc. I had letters from my PCP and OB/GYN and I have a friend who is a doctor -- he called the Medical Director and Vice Pres. of NHP up and they still have refused me. They want 6 consecutive months of diet with a doctor, nutritionist and an exercise program. I have decided maybe this is God's way of telling me not to do it -- I guess I will be rejoining Weigh****chers. Thank you so much for your kind words though.

Keep trying don't give up it is worth to fight!!! Do you have any letters or medical records or letters from your family go to any where you tried a diet ... I sent my ins everything i had from the time my doc said I was overweight to my acupuncturist to the la weightloss diet... ETC ETC i send them letters from my family, pictures basically making them feel sorry for not approving you .... Try please let me know if you want any help i am from miramar florida..... Good Luck keep me posted!!!

Did they specifically tell you it had to be a diet doctor? If not, I would start the 6 months process of dieting under a doctor's superivision with my PCP or whatever doctor they will approve. At the end of 6 months you will have fulfilled that comittment for them and then they can deny you based on that. I hope it works out for you, I really do. Don't give up!

Rosemary, my husband went through the same thing. BC/BS said he had to have 6 months of supervised diet and excersice program. He is doing Weigh****chers, (which will documnet weekly your lose and gains) and he joined our local hospital wellness center. Which he logs in and out. Good luck!! PS fight both the hospital and the insurance company. To have done the test they SHOULD of gotten a pre-cert.

This is an increasingly common requirement--cigna is counting on you to give up in the face of such an obstacle. Too bad you can't switch companies or self pay. Although there are companies that specialize in making loans(eg Medicredit)but as long as you are comfortable with this I guess the diet can't hurt. This is just so stupid--who could lose enough weight to get out of the m.o. category?