GOING BONKERS!!!!

I absolutely hate this waiting game!!!! My insurance company states that it could be another 30 days before the "independent review board" makes their decision!!!!! I think I need nerve pills or something.... my eating is out of control, I'm gaining weight, I'm itching all over.... what more can I say! I know that it would be to my best benefit to try to get healthier and lose weight before my surgery.... but, somehow, I can't seem to get that train of thought put into action. Now, I read that most people who have Ohio Medical Mutual Super Med Plus are required to go through a 6 month medically supervised weight loss program before they get approved!!! Why don't they tell you this upfront?!? Pardon me for VENTING!!! I'm just at my wits end, and fully realize that others are going through this as well..... Thanks for your support, Karen

Karen, I have Medical Mutual/HMO HealthOhio and they do require a 6 month supervised weight loss attempt. I went to St. Vincent's required meeting and that was one of the things that they stressed. I called MM today to see if they got my package from my surgeon's office yet (only been 4 days but I am not a patient person) and they were very nice about me calling. I asked them how often to call and she told me to call every day if that would make me feel better. I told her the only thing that would make me feel better is WHEN I find out I am approved! She laughed at that. Anyway.....jus give them a call and ask! They will tell you what is needed. Waiting is the hardest part! Sue

Yeah but what she didn't tell you was she will not be answering the phone

Jack, You are right! She said she won't be there because she got a promotion! Sue

Thanks, Sue! For some dumb reason, I never thought to ask them if they now require a 6 month supervised weight loss attempt. The person that I spoke to today didn't seem to be very friendly, she told me that there was no need to call back, that I would get a letter in the mail!!!! I guess it's all in who you get to talk to on the other end of the line.... I, too, am not a very patient person!!! Especially when you tend to get paranoid about a third party making decisions that your doctor should be able to do.... the doctor knows your history best and if he/she decides that WLS is necessary, then, that should be that! I get a little nervous when its the insurance company making the decision and you are merely another number... and, they are mostly concerned with their "bottom line"!!! Thanks again, Sue, for your support....

This is one of my dilemmas. I am a family physician!! How much "supervision" do they want!!!! How detailed does this information need to me- monthly weights--weekly weights?? And for the record they don't tell us as primary care providers what they expect either! I have tried to call, and they wouldn't even answer my questions.

Weights every three weeks with good notes of discussions of the patient's progress in theor chart including details about exercise, a daily food log kept for at least a month but preferably the full 6 and possibly records of a visit with a dietician are best from what I understand. Also get photocopies of any registration froms for exercise facilities such as the Y or Curves.

Hey Karen, I absolutely know what you are going through. I really feel like Medical Mutual tries very hard to get out of approving people for surgery. I, too, was never told about the 6 month diet until they denied me, and I had wasted a lot of time waiting for an approval that never came. Instead, I wa**** with a big fat denial letter and another bill they won't pay.It was for my pcp for a consultation to have the surgery. Anyway, I am now almost done with the first month of my "supervised diet" with my pcp. I only hope the time goes fast and my appeal goes through. I also am not the most patient person in town, but after many tears and "pissed off" moments, I am finally just doing things their way. Good Luck to you, keep me posted on your approval! Hugs, Jane

Hi. Six months seems like nothing, I had to go threw an 8 month and then go threw a 8 weeks diet and exercise eval before being considered for surgery. You will be amazed at how quick the time will pass by. My date is set for Jan 18th. The outcome of it all will be worth it. Good luck with everything. God Bless.