My Insurance is Hideous

I have been trying to get approval since APril 1 2003. At first I was turned down because they said that I needed three more things. I needed a psychological evaluation, a dietician consult and documentation for attempted weight loss. Well in may I had the dietician consult, and psych eval. I then got a letter from my PCP stating my weight loss attempts. On May 20 Dr Chapman faxed all my paperwork to the insurance company. I waited for weeks to hear something. Never got a letter or phone call. Finally back in June around the 21st I called Dr Chapman to check into the status. When they called the insurance they told him that I had been denied again. Well I immedialtely contacted my insurance company to find out why and when They told me it was denied May 27 and because it was not medically necessary because I didnt have a 26 week documentation of weight loss atteempts. This is a new thing that they had just added. I mean this is JUly 13 and I still have not been approved nor have I recieved a letter from the insurance company yet. I am appealing the process again. So pray that they will go for it this time.

bobbie, my insurance is also hideous. i, like you, have produced physc eval, dietician eval and diet history, yet i have been denied twice. my bmi is 49 and i have hypertention, yet that is not enough. my insurance pre-certifies through intercorp and i have nothing but disgust for them. they want 26 weeks of diet history now, so i am 3 months into that. but i wonder what the next criteria will be when i get there. i have always been obese and have always dieted.. but not medically supervised in the last 52 weeks let alone 26 weeks of it. my ob/gyn wrote them a letter and gave weights for 3 months this year where i was on prescribed phentermine and prior to that lost 112 pounds on atkins(un-supervised) and a 100 pounds on topps(supervised weekly)...not enough. i am disgusted but i am not giving up and you should try harder than ever. a co-worker of mine has not been on a supervised diet in over 2 years yet was approved(by the same company) and had her surgery yesterday. go figure!!! now that she has had her surgery, i am going to use it against them if necessary legally. she began her journey after me!!! by the way her bmi is less than mine and "no" co-morbidities. i, too, will continue to pray for you, me and all others in our situation. god bless you

Mine is pretty bad, too. I started with one doctor on December 16, 2002. I went thru all of the required tests for sleep apnea and gall bladder issues. I was diagnosed with sleep apnea and I have gall stones and fatty liver something or other. I am 5'4" and weigh 377 lbs. My BMI is 65%. I still have yet to be approved. I work for a large company - in all there are over 20,000 employees. My boss, who has the same inruance, was approved for her surgery almost a year ago and she was just at 100 lbs overweight. My original doctor left my area so now I am having to go to a different doctor. My insurance didn't pay the $235 consultation fee because it is not a covered service. I have already been denied for "long limb" (because it was considered to be experimental) so my original doctor resubmitted the request with a procedure code for "short limb" which also came back with a denial - also because it was considered to be experimenta. Now my new doctor is sending an appeal letter. This is my first day of looking at the posts from others and I can't say I have been encouraged. This is extremely frustrating.