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I hate Medical Mutual!

I am soooo sick of jumping through hoops of fire for this stupid --- insurance company!!! They sent a letter back to my surgeon that they now want a 6 month clinically documented weight loss attempt for me within 12 months of approval. Guess what??? I don't have one! I have only been on diets all of my life, but none that have been "clinically" supervised by a Doctor or a Dietitian, even though I am one. Can I document my own weight loss attempt????....Hmmmmm. Something tells me they wont go for it!! Anyhow, I did see the dietitian in March when I started this journey, then I saw her again two weeks ago, and I will be seeing her again in two more weeks, and she has been "counseling" me on what I should be doing to take off the 24 pounds they would like me to take off prior to surgery...and I have been getting weighed each time....soooo I am wondering what parameters does the insurance company hold for clinical documentation of a weight loss attempt??? Does the attempt have to be moderately successful?? What if it's "too" successful...like what if I can lose 20 pounds in 6 months? Will they then say Oh Look, she can loose weight without surgery so we aren't gonna pay....I can loose some weight...I can alwasy loose some weight...10 or 20 pounds, but never 140 pounds and it never ever has stayed off and I always always gain it back plus some more! So what the hell does a 6 month documented weight loss attempt proven....not a damn thing thats what! I can attest to that as both a dietitian and a fat chic! What it proves is that the entire insurance process is a racket and I am gettin quite pissed about the whole thing. Maybe they think idf I get frustraated enough that I will go away...FAT chance....If I get denied I will hire an attorney and I will win, so they might as well suck it up now and save us all some irritation!

Ok I'm done now, and yes I do feel a little better! Thanks!:violin:

3 Comments

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chameleon

LAP-BAND Patients

I am soooo sick of jumping through hoops of fire for this stupid --- insurance company!!! They sent a letter back to my surgeon that they now want a 6 month clinically documented weight loss attempt for me within 12 months of approval. Guess what??? I don't have one! I have only been on diets all of my life, but none that have been "clinically" supervised by a Doctor or a Dietitian, even though I am one. Can I document my own weight loss attempt????....Hmmmmm. Something tells me they wont go for it!! Anyhow, I did see the dietitian in March when I started this journey, then I saw her again two weeks ago, and I will be seeing her again in two more weeks, and she has been "counseling" me on what I should be doing to take off the 24 pounds they would like me to take off prior to surgery...and I have been getting weighed each time....soooo I am wondering what parameters does the insurance company hold for clinical documentation of a weight loss attempt??? Does the attempt have to be moderately successful?? What if it's "too" successful...like what if I can lose 20 pounds in 6 months? Will they then say Oh Look, she can loose weight without surgery so we aren't gonna pay....I can loose some weight...I can alwasy loose some weight...10 or 20 pounds, but never 140 pounds and it never ever has stayed off and I always always gain it back plus some more! So what the hell does a 6 month documented weight loss attempt proven....not a damn thing thats what! I can attest to that as both a dietitian and a fat chic! What it proves is that the entire insurance process is a racket and I am gettin quite pissed about the whole thing. Maybe they think idf I get frustraated enough that I will go away...FAT chance....If I get denied I will hire an attorney and I will win, so they might as well suck it up now and save us all some irritation!

Ok I'm done now, and yes I do feel a little better! Thanks!:violin:

Teresita

LAP-BAND Patients

The nutritionist appts can be counted into the 6 months. If you have been seeing your doctor recently, that should count, don't you get weighed when you go. Good Luck and keep up the good fight.

faybie

LAP-BAND Patients

hmmmm. You might be able to get such a thing from your PCP. He has documents of all of your weights.

Oh, thats what Teresita said... LOL... see it's a good idea... LOL.

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