My PCP Won't Cooperate!!!!

hi nereida specifically talk to your surgeons office and your insurance company -- but i'm pretty sure that BC/BS hoizon is asking for a dr supervised diet -- not just a diet that you have tried at home -- find out the speciifics so that you are not wasting any more time  good luck to you roberta

How frustrating!  Take this smiley guy to the dr. with you the next time  Maybe that will convince him I'm not sure which BCBS plan you have.  I have BCBS NJ PPO.  Earlier this year they did NOT require a "doctor supervised diet" per say - just the letter stating my weight over the past five years, my comorbid factors etc  HINT:  your weight MUST  be over the morbid obese BMI for all five years.  So, as my insurance person explained to me, if lets say in one year you were dieting from Jan to March and in March you had lost 50 pounds and was now no longer "morbidly obese" don't put down THAT weight, rather put down the highest weight from that year (the beginning of the diet possibly or after that attempt failed and you gained weight over that) I wrote the letter myself as well.  Detail the diets you have tried, the problems you experience due to obesity (high blood pressure, diabetes, sleep apnea, joint pain, osteo arthritis) etc. Keep up the good fight and use this time to learn.  Every road block, as hard as it seems, is done for a reason.  I had surgery cancelled 2 weeks before, so  I understand how difficult it is to hit them.  But you will get there. Pam

I, too, have Horizon BCBS NJ PPO, and the surgeon's secretary told me that they now require a letter from the doctor. I took everybody's advice, here in the forum, and wrote the letter myself. It wasn't anything that would compromise my physician or lie about my condition. The secretary told me that the letter should be at least three sentences long, and I wrote about my weight problem, the unsupervised weight programs I've tried and that the physician was aware of my weight problem and has knowledge of me wanting bariatric surgery. I didn't include any of my comorbidities because I assume they're going to receive those reports from the surgeon. My doctor gave me his John Han**** and I was very happy. I made a beeline to my surgeon's office with the signed letter, and when the secretary read it she said that would do. She told me she had just faxed all the paperwork to the insurance company and was just waiting for the letter. Well, I have pre-testing on December 4, and I go to boot camp on December 6, but the surgery itself hinges on the insurance company approving me for surgery. The surgery is set for December 19 and I need to report at 8:00 a.m. and the time is set for 9:30 a.m. I asked the secretary how long does it take to get everything approved and she told me that it varies so she couldn't really tell me. She said sometimes it's a matter of a couple of days, but sometimes she's had to call herself to find out. Could I call my insurance and inquire about the status of my request? Thanks everyone! Nereida

So happy for you!  That is AWESOME news. Yes, you can call the insurance company - I did too.  Didn't have to much luck, just got the run around.  I think I waited 4 weeks for an answer - but don't let that deter you.  I'm sure calling often if needed would help!  Plus, I've heard people get calls from them sooner - I never got a call - I got a letter in the mail so that took longer, too.  Your surgeon's insurance person might be able to call as well.  And Dec 19 is right around the corner! Pam

Hi Nereida, I was so happy to hear that you were able to get your PCP to sign the letter.  As far as calling your Insurance company go for it!  I called mine and they said they did receive my papaerwork but have not made a decision yet.  Then the next day I received a phone call that I was approved.  I think because I had called it pushed them into making a decision fast.  I can't hurt!!!  Good-Luck!  Let us know how you make out. Melissa

Melissa, how long did you wait before calling the insurance company after everything was submitted? Nereida

the best of luck to you nereida :) waiting for approval is the longest part of the journey  roberta

Hi Nereida, I called within the week, and I received my approval exactly a week after my info was submitted.  I hope this was helpful.  G00d-Luck! Melissa