Question:
pre-det.letter of med. necessity and office notes-too good to be true

I just called my insurance co. for the first time because I don't have a written policy to go by. She said all I needed to send to them was a pre-determination letter of medical necessity and office notes. Can this be true? It sounds too good and easy and I know that's not possible. She said nothing of diet history or anything. Don't want to get to excited.    — angela D. (posted on May 9, 2002)

May 9, 2002
Hi! Sometimes it is just that easy. Some policies only require that you have a BMI of 40 and nothing more. Wouldn't it be nice if all policies were this easy! I have patients who've gotten their approval in as little as 15 minutes. Unfortunately I have more patients who've had to wait for several weeks. Maybe one day in the not-too-distant future it will be an easier process for everyone. Best wishes!
   — ronascott

May 9, 2002
Yes it is that easy, I was approved the very next day my dr's office faxed the claims to the insurance company. Believe it or not you are almost there! Good luck and hugs. I am ready to go for surgery open RNY on June 13th!
   — Pilar E.

May 9, 2002
Yes, it may that easy if you are fortunate enough to have a supportive insurance who recognizes the importance of WLS. However, do yourself a huge favor; have your doctor be very specific about any comorbities and the severity of your disease(s) when submitting your referal. You might also consider looking at a list of comorbs on this site and have your doctor test you for any you or he/she might suspect. I you or your doctor feel WLS is for you, NEVER take "NO" for an answer. Best Wishes.
   — ERICK B.

May 9, 2002
Sometimes its just that simple. Be grateful....Good luck on your wl.
   — Karen M.

May 9, 2002
Yes it can be just that easy. I also called my insurance company to find out what they wanted and it was exactly the same. I did not have to have a diet history or anything. Just my comorbids. Then after my initial consultation with the surgeon, my insurance company required a psych evaluation. After the psych evaluation it was no time before they sent out approval letters to my surgeon and myself. Good Luck!! It is always a blessing when the insurance company doesn't make you jump through hoops.
   — sgibson71