Old Doc died - Insurance wants records to approve revision...
So, I'm in the process of trying to get approval for a revision from the VBG to the DS. I had my VBG done in 1999 with a physician who died in 2009. The hospital affiliated with the surgeon has since been bought out as well. The new surgeon's office wants records that I followed his regimen, etc (for insurance reasons - see below). So far, we have been unsuccessful in getting any records. Anybody else have this problem?
My other issue is, since the original surgery was in 1999, there is a good chance that even if we find where his records went that the records have been destroyed as it has been > 10 years and medical records only have to be kept 10 years in that state.
Has anyone else had this problem? Any help is greatly appreciated!!
Cristi
BCBS - Federal wants:
Weight loss from the initial procedure was less than 50% of the member’s excess body weight at the time of the initial procedure
· Member complied with previously prescribed post-operative nutrition and exercise program
Wow you are in a pickle aren't you?! That's not a problem that I've ever read about here in my 6 yrs on OH. I wish I had some ideas for you. Did you by any chance do Weigh****chers, or can you get ahold of whoever bought the hospital. Altho they may only have the actual surgery records. I sure hope someone can come along here that can help you. I wish you the best!
Yes, I am in a pickle to say the least. I got ahold of 2 of the ladies that used to work in his office. His records were transferred to a new surgeon in town... HOWEVER, since it was > 10 years ago - they have destroyed the records. When I contacted the new hospital (that bought out the old one), they had no record of me either.... SO, I'm back to square one.
I am hoping that BCBS understands that this is not my fault and will care enough to approve me anyway. I laughed and said, well if it's not documented then it wasn't done.... so don't tell them it was a revision.... if it only worked that way ;)
So if anyone else has had a similar issue or knows how to convince insurance, please let me know.
Thank you!!!
Well maybe BCBS would accept notarized statements from the 2 ladies that you went there and did follow protocol. 
I don't know how they can expect you to have something that no longer exists from a doctor that is dead! Maybe your current surgeon could do a peer to peer talk with their doc and get them to make an exception. Good luck!!!!!
