Looking for feedback
Hello all.
This is my frist post, so please if this is one of those "repeat" posts, I appologies.
I want to make sure I am not missing anything as I get ready for seeing if my insurance will cover my RNY. I have BC/BS of AL PPO.
Please follow everything I will be presenting to my insuarnce, please give feed back if you see that I need more or something else...
I am 6-2.5 346# BMI 43.9 I have just come from my 2nd visit with my DR, and I have lost another 5#'s. My insurance requires a 6 months weight loss attempt prior to approval. (to show a behavior modification can be made). I am using Nutrisystem as my diet.(saving receipts for insurance company).
In May of 2006 I was diagnosed with Severe Sleep Apnea (Man, what a complete difference a nights sleep can make). My Sleep Dr. wrote a letter for stating... "I had 127 events durring the first 30 minutes of the test which required them to follow emergency protocol by placing me on a CPAP." He later goes on to say that "I certainly would be a good candidate for WLS". I also have receipts for my Cpap machine that I currently use.
My medical records for the past 3 years show me with a BMI of atleast 39.4 or higher.
I am seeing an orthopedic Dr. next week to discuss my knee and ankle pains that I experience while trying to stand for long periods of times or walk any distance. I am going to ask that he write a letter supporting my plans WLS.
I have documentation of being a member of 2 different gyms for 3 out of the last 5 years.
My primary care physician is 100% behind me and will write a letter to go along with my 6 months of supervised diet and exercise program.
My current medical records will also show that I am being treated for Reflux/Gerd with Nexium. (Just no upper GI was done).
So I am hopping being armed with all the information above should get me approved.
My mother had this surgery, she had some complications but all in all she did fine. This is a great tool that we can utilize. However I currently will only be able to utilize it if my insurance company approves me. I am ready and willing to hire an advocate/esq. to handle my appeals if I do get denied however.
Sorry for any typos, it's like 2am here!
Any thoughts?
VSG on 04/29/13
From what I know from reading profiles and talking to others you are doing the right things however it may be better to ask on the main board because almost everyone is non-op or have not had surgery. Sorry I could not be of more assistance. God Bless you on your journey!