Question:
I am 22 years old and my surgeon wants me to write a history of....
I am 22 years old and my surgeon wants me to write a history of diet attemps and that this is my last resort as far as weight loss. Is there any ideas on what to say so that they can send that to my insurance company for approval, the receptionist said try not to be too sympathetic. I have an idea on what to say but can someone give me examples?PLEASE HELP?? :-( — Tashana D. (posted on October 23, 2005)
October 23, 2005
Most health plans require some sort of attempt at weight loss prior to
authorizing a procedure. A policy statment like: "The patient must
have actively participated in non-surgical methods of weight reduction;
these efforts must be fully appraised by the physician requesting
authorization for surgery" are common. What you need to show, as
objectively as possible is what you tried, how long you tried, how much
weight you lost and how much weight you gained after. Ususally an 18
months to 2 years span of time is enough. Some health plans also require
that you have attempted at least 1 physician supervised program. You may
want to check your health plan's medical policy just to make sure you have
covered what they are asking to see. Use a table format, not prose or
story form. Easy to read and tells the bulltes I described above. It is
one small step, and well worth the time.
Best wishes!
P.S. Part of your profile asks the same questions, complete it and you will
have your history :) JLB
— nursenut
October 23, 2005
Hello! I'm also 22 and at the end of my physicain supervised diet. I've
already had to go through everything I've tried and failed at, but I
personally didn't have to write anything. My physican has to write a
letter to my insurance company stating why he thinks I need it, but that's
it. Is he writing it or are you? Write me anytime at [email protected]
— Jami
October 23, 2005
How I did mine was list out all of the diet attempts I tried and approx.
when and the approx. weight loss then regain I had. I went as far back as
when I was in high school, which is where my wieght issues really started.
Then I began to tell about the current problems I have such as arthritis,
pre-diabetes, back pain, high cholesterol, and then I told of what to
expect with these problems years down the line if I could not correct them.
I mentioned the risk for cardiovascular problems and stroke, the need for
knee and hip replacements, complications with diabetes. I did not ask for
sympathy, but just told in the letter about how I feel and why I know it
would work for me.
I wish you the best of luck. If I can be of more help please email with
any questions. This stage of the process can be very slow and stressful
with insurance approvals, so just be patient. You will succeed very soon!
Shelly
— scharlier
October 23, 2005
Hello,
What I did is go back as far as I could remember. I put things like Jenny
Crai I did when I was 12 and the different diets that I tried as well as
different exercise programs that I tried. I have Blue Cross and didnt have
a problem.. So companies require that you go back as far as 10 years or so
— dillaq
October 23, 2005
2000 - 6 months - Weight Watchers (lost 15 pounds, gained 12 back)
2001 - 3 months - Dr. Atkins Diet Revolution (lost 25 pounds, could not eat
one more pork rind, gained the 25 plus 10 more)
2002 - 2 months - The Zone (6-1/2 pounds, could not keep up with
figuring/counting/planning, gained 13 back)
2003 - 6 months - South Beach Diet (lost 13 pounds, but could not stay away
from carbs, particularly most fruits - gained back 13 + 4 more, but it took
longer to regain)
2004 - 4-1/2 months - Weight Watchers again ( . . . .
I think you get the point of what they are looking for.
Missy
— Missy H.
October 23, 2005
I have the letters that I sent in with my paperwork. You are more than
welcome to use them. I was approved by Aetna in less than 24 hours! Email
me [email protected] if you would like them.
— *Malena* M.
October 23, 2005
Like one of the previous posters I too went back to my teen years, when my
problem started, with some specific and some general dates including weight
lost and gained back. I also put in current "Co-Morbidites"
along with familial history and expected problems that could arise from
obesity related issues using medical terminology. I feel it is best to
point it all out straight and forward. I was told ny my PCP's office staff
that I would probably still have to do 6 months supervised diet as that was
their "normal" policy, and I was prepared for that, but got a
pleasant surprise when I was approved for my surgical referral within 10
days! If you have any questions, please feel free to email me at
[email protected] ... Good Luck!
— Laura G.
October 24, 2005
Hi Tashana!
My Dr. required a Weight Loss History going back 5 years AND A Letter of
Support from my PCP. He providided a sample letter and history to follow,
which made it alot easier! In the weight loss history it had to
include:type of weight loss tried, the month & year starting, the month
& year ending, how much weight was lost, and how much weight was
regained. Example:
Weight Watchers: June 1997-Sept. 1997; lost 14lbs.,regained 30lbs.
I'm 39 years old now and I started dieting at 5 years old, they only needed
the past 5 years. I went back 34 years!!!
I hope this helps! Best of luck to you!
Lisa
— Lisa Michelle
October 24, 2005
I had to do that also. All I did was stick to the facts. Listed what diet
I was on and when and what the result was. Does your insurance company
have a specific amount they want? I only needed 3 documented attempts.
After I wrote it I had my PCP sign it and then mailed it off to the
insurance company. Obviously it was accepted as I had my surgery August 4,
2005
— arlene713
October 25, 2005
Tashana,
I did a very detailed history, but I had written stuff down from doing
OA..if you want a copy just email me and I'll send it to ya!
Good Luck....
Lisa lap/rny 10-23-03 340/170/???
— Lisa H.
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