Question:
HAS ANYONE WHO WERE UNABLE TO SUPPLY MED.SUPPLIED DIET HISTORY STILL BEEN APPROVED?

I HAVE BCBS OF IL HMO MED GROUP IS RUSH PRESBYTERIAN I WAS TOLD BY MY SURGEON'S NURSE THAT I WILL NEED TO SUBMIT PROOF OF ANY MEDICALLY SUPERVISED DIETS. I.E. MEDICAL RECORDS...WELL I THOUGHT NO PROBLEM UNTIL I FOUND OUT LATER TODAY THAT THE 2 PLACES WHERE I HAD BEEN ENROLLED FOR A YR OR MORE IN A WEIGHT LOSS PROGRAM HAVE BOTH CLOSED...SO IM UNABLE TO RETREIVE ANY RECORDS...AND I CALLED THE NURSE TO TELL HER THIS AND SHE WASN'T ALL THAT SUPPORTIVE TELLING ME I HAD TO HAVE IT BUT IF I COULDN'T GET IT WE'D HAVE TO MAKE DO....DO I SMELL "denial" IM TRYING NOT TO THINK LIKE THAT I DECIDED SINCE I WROTE A LETTER LISTING THE DETAIL HISTORY OF MY DIET HISTORY AND A APPEAL FOR APPROVAL,I'D HAVE THE SURGEON WRITE A LETTER ON MY BEHALF AND WILL ASK MY NEW PCP TO WRITE A LETTER ON MY BEHALF,(I WILL BRING A BAG FULL OF EMPTY BOTTLES PAPER WORK FROM ONE OF THE DOCTOR'S WHOSE OFFICE IS NOW CLOSED,PROVING I WAS ENROLLED IN HIS PROGRAM,SO SHE CAN SEE THAT I HAVE TRIED DIFFERENT DIETS. AND WRITE A HONEST LETTER.I WILL ALSO BE REQUESTING THE MEDICAL RECORDS FROM MY OLD DOCTOR,EVEN THOUGH I NEVER DID ANY DIETS WITH THEM IT SHOWS THE PROBLEMS I HAD WITH MY WEIGHT. SO WHAT DO U THINK? A LETTER FROM SURGEON ON MY BEHALF,LETTER FROM NEW PCP,MEDICAL RECORDS FROM PREVIOUS PCP, AND MY PERSONAL LETTER WHICH INCLUDES DETAIL LIST OF DIETS TRIED.DO YOU THINK I HAVE A CHANCE OF APPROVAL WITH ALL THIS? HAS ANYONE WHO'S INSURANCE REQUIRED PROOF OF ANY MED. SUPV. DIET AND YOU WEREN'T ABLE TO SUPPLY ANY WERE U STILL APPROVED? IF YOU WERE OTHER THAN THE THINGS I LISTED IM SUBMITTING DID U SUBMIT ANYTHING ELSE IN PATICULAR U FELT MIGHT HAVE GOTTEN YOU APPROVED? ALL ANSWERED APPRECIATED.....THANK YOU    — DEIRDRE D. (posted on June 26, 2001)


June 26, 2001
Low and behold I've found someone in my shoes...I have the same problem...I have medical records that show my weight but the few places that I've been 1) dr. has moved and cannot locate 2)went out of business..it has been over 5 years ago but it was an attempt..still i've been on so many diets that I cannot even remember. I'm writing down down every diet that I can remember and I'm also having friends sign statements tht I was on a particular diet at one time. getting any additional medical records has been disappointing to say the least. My faith in doctors has been shattered. I have a commitee appeal on July 3, to re present my case. I have faith that they will listen and hear my desparation...
   — vmckel3783

June 26, 2001
Hi Deirdre, I have BCBS PPO and was denied twice. The first time the ins co asked for MSD history also. I had only recently started going to my PCP (about 9 months) so he only had documentation of 2 diets and I hadn't lost more than about 5 pounds between the two. But since you have proof and your PCP will write a letter to confirm this, that may be enough for the ins co. I think what helped me to get approval was a letter sent from my pulmonologist explaining that I have sleep apnea and need CPAP therapy and supplemental oxygen. They received the letter 2 days before my appeal was to be reviewed for the third time. So if you have life threatening comorbs, it would be a good idea to have the relevant specialists write letters on your behalf. Also submit copies of the proof of MSD tried. I wish you all the best.
   — dandjon

June 27, 2001
I'm in the same boat right now! The insurance company wanted receipts or cancelled checks -- what a hoot -- some of these date back 25 years. Anyway, I was able to track down the women who ran the two diet places that I went to and they said they would vouch for me because they remembered me. So I put down the name of the place and the lady's names and phone numbers. I just faxed the diet history in a few minutes ago...............Rose Hammes
   — Rosie P.




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