Another insurance ???

[AmyZ]

I have BCBS (Ohio) and the paperwork they sent doesn't specify a "supervised" 6 month period. It says

"The individual must have serially documented active participation in a non-surgical weight reduction regimen for at least 6 continuous months, in the 2 years prior to surgery, to enable both behavioral changes and adequate assessment of anticipated postoperative dietary maintenance. These efforts must be appraised and documented by the physician requesting authorization for surgery,..."

My question is this... I kept a binder last year where I recorded my daily calories consumed (breakfast,lunch dinner, snacks & total for the day), average weekly calories, my weekly weight, monthly measurements, daily steps & average weekly steps. I have 30 weeks of information. Would this be an acceptable record? Or will I still have to do the 6 month supervised, even though it doesn't specifically say that?

I haven't had my initial consult yet - have a call in for surgeon and hope to get a call back on Tuesday. I already have a referral from my PCP and his support, a BMI of 47.9 with high blood pressure. I also have a record of talking to my former (she retired) PCP about weight since 2005. The surgeon & PCP are in same health group at same hospital.

What do you think? Thanks!!!

[thenewmetoday]

I have no idea, hope you get helpful feedback. Just want to say good luck!!!!!!!!!!!

[Pam G]

It has to be from the doctor's office. Just take all your documentation to your surgeon...they know how to write it up to please the insurance companies.

[AmyZ]

It sounds like it's just up to the surgeon to make sure it's done, right? So if the surgeon feels it qualifies, he can "appraise and document it", right? That's what I'm hoping!! I've prepared myself to hear that I have to do a 6 month diet, but it would be amazing if he said that satisfies it and we can start on all the other required appointments.

Patience is not my best quality!!

[Pam G]

It sounds like it's just up to the surgeon to make sure it's done, right? So if the surgeon feels it qualifies, he can "appraise and document it", right? That's what I'm hoping!! I've prepared myself to hear that I have to do a 6 month diet, but it would be amazing if he said that satisfies it and we can start on all the other required appointments.

Patience is not my best quality!!

Yep, it's the surgeon's job to send in the pre-authorization request. Many insurance companies want to see that you've tried different diets/plans and failed. They also usually want a psych evaluation, so check your policy for that, too. All other stuff, like EGD or cardiac clearance is up to your surgeon.

[gammagirl7]

my insurance wouldn't pay and so I choose weightlossagents.com great price and less rope to jump thru! good luck!

[KariVSG]

Insurance companies are very strict with their guidelines

[Pam G]

[QUOTE=gammagirl7;551086]my insurance wouldn't pay and so I choose weightlossagents.com great price and less rope to jump thru! good luck![/QUOTE

I think I paid more going through my insurance than had I gone to Mexico!

[gammagirl7]

I'm so happy I chose this route..

[Soundr]

Interestingly, somehow all of this comes to be positive just because of luck or because some people care about others for real. For my life-insurance with best protection plan was almost a nervous sweating process where my moral state was very overwhelming, feeling like signing papers with a bad ending for me. But, after time understood the importance and privilege to have such protection. It’s not always about ourselves, but it’s about our family. As a man we need to do our best, if there are now many options, we need to use the best ones available and possible for us to change the situation to our favor.

[Jarovan]

thinking of getting another insurance, but i'm not sure if it works out okay for me