INSURANCE REQUIREMENT UPDATES

Well, I just got my happy bubble burst and am back to chewing off my fingernails!  Boeing Traditional dropped its 12 months dieting down to 6 months.  That was great.  Got my information sent back in - thought I was there and could get surgery right away.  Well my documentation wasn't good enough.  My doctor has been documenting my progress with weight loss, no gain, chart notes mention my dieting/eating habits and what I'm doing for exercise.  That wasn't quite good enough - they want more structure to it - they want to know specifically what I am doing for daily exercise, specifically what I'm eating - a spelled out diet I'm following....So here I go again.  Hopefully this will be a heads up to any one else going through this ridiculous insurance process.  Then also beware - many insurances only give you three chances to appeal - and they can count any new information you send them as an appeal.  So now I'm going to spell out specifically what diet I am following, keep a daily journal of everything I put into my mouth, and note specifically every second of exercise I do and spell it all out.  I'm sure my insurance company will love it when I send them about 50 pages or more on my next appeal in a few months.  Also be very careful - when you receive a denial back from insurance, mine and others tell you that you have only so many days to respond or make a new appeal - mine is 180 days.  If you don't do it by then - they can close out your whole case! 

If anyone has any more helpful information to me and others - please let us know - Thank you! 

ragadolly/Donna

Oh how frustrating, poor Donna!

All this effort alone should show them how serious you are about this.

I'll cross fingers for you.

 Hi Donna. I have Boeing Traditional, also . Luckily, I got my approval before that July change that  they did. My first surgeon required very precise food and exercise logs,along with a diet of 3 small high protein,low fat ,no sugar meals, and 2 protein shakes . They required 30-45 minutes of aerobic exercise at least 5 days a week. I did walking,water aerobics,and water walking. That helped me lose 39 pounds before surgery. I was frustrated with all the hoops they make you jump through, but looking back, it helped me get in better shape for surgery. It also gives you some time to get off sugar,sodas, caffeine, and carbs. They also  had me practice eating very slowly, which seemed crazy pre-op, but trust me , you have to eat very slowly post-op, and carefully chew things. They even had us get started on the vitamin routine before surgery. It really helps to practice all that stuff before surgery. You are overwhelmed enough just recovering from surgery to have to learn all that stuff after surgery! Use this time to learn as much as you can about protein, vitamins,and finding types of exercise that you enjoy.As it turned out, my original clinic closed it's WLS program, and I had Dr. Lauter at Overlake, *****quired no pre-op diet at all! He is a great surgeon, and I breezed through surgery. I know it definitely helped me to do all that preop stuff. In fact, I still keep food logs to make sure I'm getting all the required stuff, and not too much of the "bad" stuff. I slacked off on the food logs for a couple weeks, and my weight loss stalled. I need the logs to keep me honest.
Good luck to you, Donna! Hang in there I know this has been very frustrating for you, but we will see you on the loser's bench soon.