6 month diet question

Ellen H.
on 2/15/07 10:35 am - Metro Detroit, MI
Hello I am embarking on my journey toward WLS.  I have been denied once and am currently getting all of my ducks in order for my appeal.  My question is regarding the wording on my appeal letter.  It said that I was denied because documentation had not been provided that proved I had been significantly overweight for at least five years and that I had participated in a 6 month diet.  Well I have actually done both of these which leads me to my question.  The overweight more than five years part is an easy one and the surgeons office has that ready to go.  So I did go to a Dr supervised diet clinic a few years ago and happened to have gone there for seven months.  The thing is the date of my last visit there was 1/30/03.   Now my questions are if anyone can help me: 1.  Will the insurance company consider this to have been to long ago?  The denial letter did not specify and sort of dates it just said 6 month diet. 2.  Since I lost weight will the insurance company say that I can lose weight on my own?  I had gotten down to 270, but am now currently at 350.  I am curious if that would be considered in my favor, against me, or insignificant.   I guess that I am really asking, if from what I descibed from my denial letter does this sound like I am ready to send the papers over for my appeal.  I just started weighing in at the surgeons office just to be on the cautious side and to not lose anymore time.  Unfortunately I have an insurance company that rarely if ever approves surgery, but I would like to remain optomistic.  I do have one of the best policies that they offer. Any and all responses are greatly appreciated.
kathyy68
on 2/15/07 11:08 am - Tomball, TX
My insurance company stated that the 6 mo supervised weight loss had to be within the last 24 months and had to be consecutive. Of course all insurance companies are different, but that might be a problem for you. Could you call them and have them specify what they want? Also with my ins. company, they didnt really care if I lost or gained...just that I stuck with it and went the full 6 months. I ended up gaining a pound on my last visit. I was approved 1 day after submitting my file. Good luck! Kathy

289/276/188/150
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IROCK916 :)
on 2/18/07 4:01 pm - BFE, CA
RNY on 02/21/07 with
In regards to the 6 month diet. I was given a form by a fellow OH'er that worked for her. I had my doc (who's been seeing me from skinny to morbidly obese) sign it off and it was approved from my insurance. If you'd like, message me and i'll send it to you...  best of luck,  Stephanie
I ROCK BABY!
 
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