Insurance

i HATE iNSURANCE I gess I will have to do 6mo dite agin because they don't like that the Dr just weighed me and put it on a paper and not in a form saying that I had lossed 2 lbs by walking and such for each mouth.Oh brother this is trying me to the max. I give up this is all I need to do now. Jan

Bless your sweet frustrated little heart!  I had two denials before I got approved.  But...all may not be lost!  My insurance company originally said the same thing (not enough detail on the PCP records) but after we revised the paperwork to be more aligned with the criteria set by the insurance company...I was approved.  It was the exact same 6-month diet, just reworded to fit the requirements of the insurance company.  I had to include my nutritional goals, weight loss goals, behavior pattern changes, etc.  It looks like you are going through Vanderbilt...yes?  Well, my guess is that you have all of this material already.  Did you meet with Molly or another nutritionist?  If so, she gave a sheet with some nutritional goals listed on it.  Mine included things like eating 3 meals a day with no snacks, limit of one Starbucks latte per week, sweet tea was reduced and eventually eliminated...you know, that kind of thing.  Exercise goals would be things like walking 10-15 minutes before lunch or parking farther away from your office.  You probably just need to revise the way you present what you have already done and then it will all work out okay.  Please don't give up...I was discouraged after my second denial but it just made the approval that much sweeter! You can do it!!! Freddie

Yes I am going to Vanerbuilt and I do have the papers they gave me I will try retiping them and get my Dr to sign off on it this week Thanks Jan

Jan, Don't give up, just have your doctor to fill the papers out like the insurance company want it.  You have done the diet and you shouldn't have to do it again.  Just talk with your doctor and explain, if the doctor is on board for you to have the WLS, it should not be a problem to re fill out the papers. Darlene

Dr. Spaw's office provided me with a form and my insurance CIgna took it with no problems, maybe your Dr. has a similar form and your PCP can go back into your records and complete this form and it can be resubmitted..  Just  a thought!!

Before you do anything go back to your PCP and get them to just REWRITE up the forms the way that the insurace wants them to be written, if the PCP is too busy to do it talk to one of their nurses you can make an appointment JUST to talk about the stuff and tell the nurse EXACTLy what you need from her and explain it all and then just ask them to take pity on you and to PLEASE help.  I've heard several people say that if you can find just one person in the PCP's office that will support you then they will help you get thigns done and it wont hurt them to take the time to write up your forms again especially if you make an appointment JUST for that reason.  Something to try before you have to do the diet all over again. Hopefully that will work and you wont have to be another 6months longer for them to get their act together at the insurance. Hugs,