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Hi Melody,
Not sure if this is helpful, but the reason my surgeon needed records was to document my weight over the years. (I assume because insurance wants to make sure this is an ongoing issue and not a recent/temporary weight gain). I had issues finding this because I, too, did not regularly see a doctor. I was able to patch together some records from the past 5-10 years by using some odd sources. Here are some of them:
1) Gym Membership Sign-up to Curves - They had weighed me at sign-up
2) Medical study I had participated in
3) TakeCare Clinic at Walgreens
Hope that helps at least a little! :)
Lap-Band 2011 | DS Revision 9/28/15 | HW: 380 in 2011 | GW: 140
Blog: http://felicitywls.blogspot.com/ | Twitter: @FelicityQ13
Something like a record of your weight loss attempts with Weigh****chers..something documented to show you have attempted weight loss before.
Melody
HW: 394 SW: 359 GW: 187
I have to leave Aetna for at least 6 months (didn't fulfill my hourly requirement thru my job) I was told COBRA would keep everything the same but I am finding myself stumbling from one road block to another and was hoping someone could tell me if there is an insurance company that only requires the 2 week liquid diet or something less time consuming than Aetna.
Figured, if I am being forced to change insurance companies, maybe I can find one that won't make me wait so long or won't require a PCP to sign off on it too.
Any info you have would be helpful.
Thanks!
Melody
HW: 394 SW: 359 GW: 187
I have never had insurance for long periods of time. I hardly ever went to the Doctor as a child and as an adult the insurance coverage was always spotty or non-existent. My current insurance provider Aetna, said I needed PCP records but my surgeon said not to worry about it. I haven't had a PCP in at least a decade. Now I am seeing other posts where the Insurance was denied because of lack of records.
Is there anyway to be approved w/o 3 months of Primary Care Physician records?
Melody
HW: 394 SW: 359 GW: 187
Oh no! Now I am scared. I don't even have a PCP because I never had continuous insurance before. Am I doing all of this for nothing too? God, I hope not. I hope everything works out for you.
Melody
HW: 394 SW: 359 GW: 187
I've not had that issue but as someone who used to work at a health insurance call center, I've seen things like this work out for people by arguing that you went to a contracted WLS doctor and that you did NOT choose the clinician for the psyche evaluation and therefore THEY should cover it. I would recommend that if they do not want to cover it to inform them you would like to appeal and ask whether they have an appeal process if so go through that, if NOT or you have exhausted the health insurance companies appeal process then you have a right to appeal to your states Dept. of Insurance.
I got an approval letter from iehp to see a surgeon yesterday. :)
I received information from my insurance today and they require a 12 month continuous medically supervised weight loss programs. I've seen 3, 6, and even 9 month requirements but 12 months?! Anyone else encounter this and how did you deal with this situation?
some ppl have met the 12 month req. by having seen their doctor regularly when diet and exercise was discussed.
The ppl who haven't had the dr visits,just had to start with month one and do it for a year to qualify.
there is also self pay,if you are able.
I received information from my insurance today and they require a 12 month continuous medically supervised weight loss programs. I've seen 3, 6, and even 9 month requirements but 12 months?! Anyone else encounter this and how did you deal with this situation?
Hockeymom87 · 0 replies · 611 views
