Question:
A couple of questions about qualifying for surgery

First question, I have M-Plan (prohealth indianapolis) Dr. Huse is not in my network and I am having A LOT of trouble getting an out of network referal. I was just thinking about it, and I thought what if I go ahead and pay for the consultation vist I found out that is $125 Does anyone think that if Dr. Huse thinks I am a good candidate for surgery that M-Plan will pay? Second question, I am 5'2" and weight about 220 I have GERD and sleep apnea. Does anyone know if that would be enough to qualify me for the surgery? I also have a lot of lower back pain but have never been to the doctor for it so I don't think that would help me any. Also I know that my insurance wants 18 months of documented physician supervised diets or exercise , behavioral therapy or pharmaceutical therapy, the only problem there is the doctor has put me on many diets but none are in my medical records. I have been to jenny craig and weight watchers, but it was so long ago they cant find any record of it. What should I do?? Someone PLEASE HELP ME!    — Christina S. (posted on April 25, 2001)

April 25, 2001
First of all I would find a doctor who is in your network. Then call that surgeon and find out what doctor's have referred patients to him. Then find one of those doctors to refer you. I was lucky and did not need too much back up. I told them about Jenny Craig and Weight Watches and that I snore like a truck driver. I also had... (see that word HAD) high blood pressure. I am 5' and weighed 236. After 3 &1/2 months I am 179. Best of luck
   — marlene R.