I'm new here and looking for advice
Hello everyone. I am just starting my process of meeting insurance requirements for my surgery which I think I have decided to do RNY. I have a busy job that takes me out of town often so scheduling appointments is difficult. Although as of today I have every one scheduled before I leave town again. My doctors office has said that I could use my past WW attempts toward my 6 month waiting period. Has anyone had experience using WW documents for that same purpose? And what documents did you use. I appreciate any words of encouragement. It's not easy going thru this alone. It's great that there is a website for us to access.
just wanted to say welcome to the sight and i hope you will find the information you need. you have a nice day 
Welcome! The OH website has been incredibly useful and supportive in my journey. Poke around everywhere - all kinds of hidden gems tucked into forums and message boards.
As for WW and insurance, it sounds like your bariatric clinic has a good handle on what is needed for approval. Let them take care of it. Honestly though, I wish I had learned (and practiced) more before surgery during my 6 month supervised weight loss - would have made the first 8 weeks or so after surgery much easier.
As for WW and insurance, it sounds like your bariatric clinic has a good handle on what is needed for approval. Let them take care of it. Honestly though, I wish I had learned (and practiced) more before surgery during my 6 month supervised weight loss - would have made the first 8 weeks or so after surgery much easier.
7-09
Welcome to the board! I have a Aenta-managed plan but remember that companies negotiate different terms and coverages to meet their budget and requirements. You need to first call your insurer's toll-free number and ask if they have a clinical bulletin on weight loss surgery. This document outlines how they handle the claims including pre-approvals, qualifications, etc.
I am also a long time WW member and still am. Aetna did not recognize my WW program. My insurance basically read that the 3 month diet and exercise supervision had to include office visit notes that included counseling on weight loss, exercise and nutrition. My WW card just didn't carry enough information and more important; there is no counseling by a doctor involved with WW.
It may be different for your insurance. As a person who works for an insurer, I can tell you that claims are evaluated on the completeness and accuracy of of the required information. That is why you need to personally monitor what your surgeon and doctor are documenting for submitting. Don't be shy about asking questions and asking to see documents. I personally had my doctor give me the office visit notes after each visit.
I am also a long time WW member and still am. Aetna did not recognize my WW program. My insurance basically read that the 3 month diet and exercise supervision had to include office visit notes that included counseling on weight loss, exercise and nutrition. My WW card just didn't carry enough information and more important; there is no counseling by a doctor involved with WW.
It may be different for your insurance. As a person who works for an insurer, I can tell you that claims are evaluated on the completeness and accuracy of of the required information. That is why you need to personally monitor what your surgeon and doctor are documenting for submitting. Don't be shy about asking questions and asking to see documents. I personally had my doctor give me the office visit notes after each visit.
Follow my journey to a happy, healthy, active life at TomBilcze.com
I did WW for my 6 month diet... BUT I saw my PCP 7 times for my 6 month diet. You need to have 7 visits coded as "obesity". That's pretty much standard for several of the big insurance companies. I have CIGNA.
Welcome to the board!!!
I kept 6 full months of daily WW logs and sent that ALONG with all the required paperwork, 6 months of weigh ins, and a personal letter I wrote to the insurance company.
I have copies of all of this (excel spreadsheets and word documents) if you want me to send them your way just PM me your email addy.
Tony
Welcome to the board!!!
I kept 6 full months of daily WW logs and sent that ALONG with all the required paperwork, 6 months of weigh ins, and a personal letter I wrote to the insurance company.
I have copies of all of this (excel spreadsheets and word documents) if you want me to send them your way just PM me your email addy.
Tony
Hey dude, and welcome.
Can't say I can help you answer your question. I have no experience with WW. I hate support groups. I'm usually the least supportive there and I find it difficult not to laugh or roll my eyes when someone spills their heart out, so I try to avoid them like the plague. That's why I like internet groups like this. I can type "Ahh..." while rolling my eyes, and no one is any the wiser.
Despite myself, this is a good group. We have a lot of experience between us, so if you have any concerns, don't be afraid to ask. I promise I won't laugh or roll my eyes...
Cheers,
Chris
Can't say I can help you answer your question. I have no experience with WW. I hate support groups. I'm usually the least supportive there and I find it difficult not to laugh or roll my eyes when someone spills their heart out, so I try to avoid them like the plague. That's why I like internet groups like this. I can type "Ahh..." while rolling my eyes, and no one is any the wiser.
Despite myself, this is a good group. We have a lot of experience between us, so if you have any concerns, don't be afraid to ask. I promise I won't laugh or roll my eyes...
Cheers,
Chris
I think it depends on your insurance company. I had Aetna and all I had to do was fill out a form saying I had tried weigh****chers, Jenny craig Atkins etc. I did not need any documentation. I was actually amazed at how easy it was to do. I decided in Dec to go for the surgery and was approved by March and had the surgery in April. I do think my insurance was good and my dr had someone working for him who is skilled at getting insurance approved.
Good luck in your journey, you will find a lot of support on these boards. I know I did.
Kevin
Good luck in your journey, you will find a lot of support on these boards. I know I did.
Kevin
RNY 4/27/2009 Highest weight 296 Current weight 175 .!
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