Denied. Can I just vent a moment?
Good Morning- I just spoke with my insurance coordinator regarding my revision. I was denied. She said my insurance cited sedentary lifestyle and not eating the proper diet. UMMM, I have spent YEARS with the same trainer who would say differently. I ran a 5k and did the 60 mile walk!! WTF are they talking about I have been sedentary since my RNY?
It is true that I have been sedentary since June 2013 and suffering severe sciatica down both legs requiring me to walk with a cane! Ive been to chiropractor, physical therapy and neumerous appontments to pain management for injections and nerve burns as well as acupuncture. All covered by said insurance.
I have months worth of receipts for MediFast where I have attempted to get back on track with diet since I have been 'sedentary'.
They said if I do a 3 month diet and have another psych eval they will reconsider. I already know my insurance plan requires 3 month diet and psych eval for a revision. I would have been fine if they just said that. Im calling BS on sedentary. I COULDNT FREAKING WALK. Ive just been able to walk without the cane since christmas. I still cant walk my dogs cause its too far. ugh.
Thanks for listening. Waiting for the office to call me back to setup my diet plan.
I hear your frustration. I've been on a 1100-1200 calorie diet with increased activity (walking) for last 4 months for insurance company to approve. My issue is metabolic and I've lost 4 lbs. Even though you had a reason for your inactivity, it would still be considered sedentary for insurance classification purposes (especially this has been an issue for 18 months). Now that you're able to move some, along with a diet, this is your time to show the insurance company you are complying with their request. Keep a daily diary of your diet and activity. Add comments, good and bad. On the 17th day of my diet, I had a hunger binge and went crazy in the afternoon eating every 2 hrs. When I added the calories, it was 1600 for the day (the amount I need to maintain my 230 lb body!). I have knee and back issues, so I documented on those days why my activity was low. The dietitian and surgeon were impressed with my diary and knew that I was serious about having a revision. I know you can do this, you seem to have the ability "to show them!" Use all that energy of your frustration "to show them." I will see my surgeon Thursday and he will send in a completed request to my insurance company, so we can get this process going. I hope I have helped and encouraged you.
