Question:
i;ve just attended orientation,got my package to fill out. now i want to know what to

do next.i;m 5ft.0 in. and 275lbs. and tired.contacted my pcp. that i'v only been with for 3yr nosupervised. diet.only what i did for myself. nutri-system about 15yrs ago. phen-phen,and others but no record. what to do. i'm desperate.    — peace (posted on November 25, 2005)

November 25, 2005
Hi Martha, Not sure what your insurance co.'s rules are but I had Aetna and I initiated a doctor supervised diet with my PCP. I waited until I had 3 months of documented notes from my dr. on diet and exercise then I submitted my packet to my insurance co. with my own personal letter which detailed all of my comorbidities as well as the diets I have been on myself. I was approved. They just want to see that you have made an effort (my opinion). I wouldn't submit without at least getting a few months under your belt. Just depends on your insurance and who gets your case. I had Aetna and was a 40 BMI with diabetes and arthritis in my knees. Hope this helps a little.
   — sherita

November 25, 2005
Make an appointment with your PCP and discuss the WLS with them. Also, contact the surgeons office that you have selected and the person collecting the packets and making the appointments would be a good source of information for you. If they have a website, they should also have a contact person listed in the information you have. Go to your insurance companies web site -- I did this with CIGNA and they have a position paper on the surgery as well as what the requirements are in order for the surgery to be approved. You have the contacts available to you -- reach out to them.
   — the7thdean

November 25, 2005
I got with my pcp and asked for copies of every single dr apt and blood work test results. I made a list of my weigh-ins with the dr. I made copies of my prescriptions, a copy of my weight watcher booklets, anything I thought would help with my approval process.
   — Danita S.

November 26, 2005
Check with your insurance and see what it is that they require. I did this and then submitted the information requested and in the mean time started a documented diet with a dietician. I then resumitted what they requested. I had to go through the appeals process but since I had submitted previous paperwork for everything they requested at the end no matter the denial reason it was documented with what was needed and eventually I was approved.
   — 1968 Loser

November 26, 2005
First, contact your insurance company or go to their website and find out the requirements (ckinical guidelines) for approval of your surgery. then, get a PCP appointment and begin a supervised diet and exercise program. While you are on the program, go to the surgeon and get an operation date for two weeks after you will be finished with whatever you need to do to get approved. If you are not approved, you can always change the date, but at least you will be set to go once you are approved. All insurance companies are different, so it is best to go right to them and find out what to do. If they require you to see specialists, such as cardiologist, etc, you have time to do that while you are working on your diet.
   — Novashannon