Recent Posts

ValMartin
on 8/19/10 2:05 am - Houston, TX
Topic: RE: Finally!
Thanks Guys!!
kendallj
on 8/18/10 7:41 pm
Topic: not the primary
I am not the policy holder on my insurance, that woule be my mom. I called and asked about gastric surgery and was told no.... I know many people are denied this off hand at first.... how do I get the insurance company to pay for this? I am bound and determined to do this.... I don't expect them to pay for it all... just the majority... my parents said they would help me with copay as long as it's not above a couple thousand. I just need to do this surgery and with my family history of heart disease, type II diabetes, and other obesity related diseases I want to avoid them (if I don't already have them!) What do I need to do?

THANKS!!!!
Love tons,
Kendall

    

    
fordrachel
on 8/18/10 3:58 am - memphis, TN
Topic: RE: Letter of Medical Necessity - samples needed!
I was just denied for LAP-BAND through CIGNA HEATHCARE, Monday August 16, 2010... I plan to use NAN's sample appeal letter too!!  My denial letter states the denial is from 09/01/2010 to 12/01/2010. Does that mean they wont even consider an approval until AFTER the denial period is over?

              
Hello... My name is Rachel, I am 5 feet tall.... sign in BMI 40.4...  pleased to meet you!!!
Starting BMI between 35 and 40ish? 
Join us on the Lightweights Board!
leeta13
on 8/16/10 12:29 pm - Montgomery Village, MD
Topic: RE: priority partners ??
hi can you tell me how eveything works i live in gaithersburg md and have priority partners
indiana_mark
on 8/16/10 3:06 am - Wheatfield, IN
Topic: RE: My ins co won't disclose pre-reqs to me
If you find out let us know, I am also in the same boat.  I have contacted my insurance company and recieved the same answer.  I had to put it back in the doctor's hands and see what happens.  It is hard to deal with this part of it.  Hope it works out well for you. 

okirishchik
on 8/15/10 1:33 am
Topic: Is it even possible?
 Is it even possible to get WLS with terrible credit (bankruptcy) and no insurance (self employed) ?  I just wonder if it is even worth my time to try.
 http://www.moretolifethanchocolate.com

My Blog. My Life.
akindofmagick
on 8/14/10 1:01 am - MD
Topic: RE: BMI Calculators
 So -  with a body fat of 43.5% and 90# of fat - does anyone know if the insurance company considers body fat in addition to BMI???

Sheri

I've been fat, and I've been thin - and thin is better.  

There is a better way. --Alaine of Lyndar 
--------------------------
HW: 234. SW: 228 (18 June 2015). GW: 137. Specs: 50ish, 5'4"

akindofmagick
on 8/14/10 12:55 am - MD
Topic: RE: BMI Calculators
 They can't go back and change their files (anyhow, my docs' charts are all electronic). Not unless they want to risk a lawsuit for insurance fraud.

Sheri

I've been fat, and I've been thin - and thin is better.  

There is a better way. --Alaine of Lyndar 
--------------------------
HW: 234. SW: 228 (18 June 2015). GW: 137. Specs: 50ish, 5'4"

Topic: RE: BMI Calculators
You know, in cir****tances like this, I find my moral compass shuddering a a bit and I think "Can't the doctor just write something down in the chart?  UGH.  Couldn't the doc "estimate" or "remember"
what your weights have been?
 Lucy van Pelt 
 Highest 255 Surgery 248 Current 170
Goal: 150
 

            
akindofmagick
on 8/13/10 8:20 pm, edited 8/14/10 12:55 am - MD
Topic: RE: BMI Calculators
I don't get a date until I have approval from Aetna. 

I hope they're not sticklers, but my PCP simply didn't have a weight in 2008 - only 2004, 2005, 2006, 2007, 2009, 2010. I also somehow managed to skip my ob-gyn appt in 2008.  Have been racking my wee brain for two weeks and despairing... suddenly realized I'd had an ear infection in Oct 2008 and had gone to a Patient First place on a Saturday night.

None of those dates have caliper measurements, tho.  I'm wondering if I should get caliper measurements on Monday to corroborate the Omron device's assessment of 43.5 % bodyfat.

Funny thing:  The guy at the gym was a bit taken aback when the device's results appeared and I started jumping up and down in excitement!!!  He'd offered to show me how to use it and let me take it to the bathroom to use in privacy - but I declined - too many buttons - just enter the numbers:  height, weight, age, sex, then hold onto the metal handles while it runs a signal (a low degree of electricity, I think??) from one hand to the other.

I'm going to include a photo of me with my daughters and a personal letter with my PCP's letter of medical necessity.

"Orthogonal" is a word used fairly often in my extended family, so I can't really take all that much credit for it!!

Sheri

I've been fat, and I've been thin - and thin is better.  

There is a better way. --Alaine of Lyndar 
--------------------------
HW: 234. SW: 228 (18 June 2015). GW: 137. Specs: 50ish, 5'4"

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