Need some assistance with my appeal...please!!

Lisa S.
on 4/18/12 1:45 am - NV
VSG on 07/09/12
Hi all. I am getting my appeal ready. But I am hoping to gather some info first. If you don't mind sharing, I am needing, specifically, what insurance you have and how long was your medically supervised weight loss requirement. For example: Amerigroup (Nevada Medicaid), 3 yrs.
I am finding that most insurance copies require 6 months. Mine is 3 years. Yikes. So I wanted to include that data along with all the other info I have. Thank you so much...I greatly appreciate it.

    


 


considering2012
on 7/17/12 9:13 am
UHC  PPO- no medically surpervised weight loss required.
Lori F.
on 7/23/12 3:16 pm - Chula Vista, CA
 3 YEARS? Dang! Cigna was 6 months but I just saw posted elsewhere it changed to 3 months. 3 YEARS is ridiculous!
Pre-band highest weight: 244
Pre-band surgery weight: 233
Lowest: 199 ( for, like, a day)
CW:
260 (yes, with the band!) 
Current Fill: 5cc in 10cc band
BMI: 49
Carmelita
on 8/24/12 5:29 pm - Four Corners, NM
So ya self paid for VSG..oh well at least your on the road to RECOVERY from obesity! ..I was looking up some ins. info that a gal PMd me about today...and found Amerigroup NV handbook...I'll put the link here anyway....in case someone does an OH search and needs it. 

AMERIGROUP NV

Pg 28 & 29

I don't see anything requiring a  3 year medically supervised diet.  

They do cover bariatric surgery....which appears to include VSG
since VSG has been legit with its own billable CPT code 43775 since Jan. 2010 ...no longer considered experimental/investigational + MEDICARE approved VSG June 27, 2012
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