JDUB0414

Hi All, I'm a 27 year old AAF and found this thread to be very interesting. I'm usually very argumentative when it comes to spats like this, but I think that the initial post wasnt read correctly by some. She was just asking if anyone had found any research on this and from that some people are taking it very personal. Everyone is different, so there may very well be truth in AA loosing weight at a slower rate. If you think otherwise, there's no need to get upset about it, just state your opinion and move on. I will be going to my consultation on 2/20/08 and am hopeful to get my band date for early March. I'm so happy!!!! I will say that I'm excitied about meeting other AA who are getting or who have had the band. Congrats to all of those who have had success and who will be getting the band.

My doctor wrote a letter on her letter head with the year and my weight for that year.

reif 78, How many years did you have? Do you hace a copy of the letter that your dr. sent?

My husband and I both have Aetna. I've been approved and my husband hasn't. The reason is because he doesnt have 5 year weight history. He only has 4 years. We've spoken to the insurance company and they say the surgeons office has to resend the info. The surgeons office says we have to resubmit it ourselves. Because we only have 4 years, I dont know what else we can do. If there is anyone out there that can give us some feedback on appeals that would be great. Any advice would help.:smile:

I have Aetna, yes they are strict. I got approved after the whole six month diet and after six weeks of submitting my papers. My husband on the other hand had the exact same thing, but only had 3 years of weight loss history....only because he hasnt been to the doctor, and got denied. Now we are trying hard to find to figure out how we can appeal.

Hi All, I'm going to have the surgery by Dr. Delatore sometime in March. Any good/bad feedback with regards to this doctor?

Congrats on you approval:biggrin:

Even though it took a while for them to approve me I think....I got approved after 6 weeks or so. I've had a BMI of over 40 for the past five years but have absolutely no co-morbids. The previous poster is right, I think it depends on the person reviewing your file and what mood their in. Good Luck.

right!!! As of today they doctors office still doesnt have my approval letter and wont do anything till they get it. I've had mine for a few days now and the nurse finally said I can send her a copy of mine. The insurance company doesn't know why they have received it yet, but said the nurse could call her and she will give her all the info she needed for the approval. The nurse refused to do that and said she needed it in writting. What makes this worse is that, the class that I have to go to wont be offered again until the end of next month!!!! OMG what the hell is going on!!! I'm so sick of this unecessary bull crap. I asked the nurse today why so many simple things are falling through the craks and no once seems to care. She didnt have an answer of course.

I'm a high shool Spanish teacher

jess4houston-I think curves will only count, if your doctor puts that in your file during your visits. I have a form that I got from another member on here that my doctor filled out. We sent that instead of all her medical notes. It worked. Annielkd-thanks for your motivating words. I cant wait!!!

that's good destiny. i'm waiting on my surgeons office to call me now, so I can find out about the fills.

Circa, that is ridiculous!!! Instead of me sending the entire file. My doctor sent a letter on her letterhead, with the year and weight I was at that year. It look similar to this. 2007-340lbs 2006-320lbs 2005-300lbs So on and so forth. the reason my husband want approved was because he only had two years. we found the other three years and will be sending them asap. Because he didnt have them, they also deemed him not medically necessary...he weights about 310lbs!!!

thanks!!!!!

we luckly found one. He went to the knee doctor one year and a clinic another year. so hopefully it will work. He has an appt on wednesday. which will give our pcp with a record of 2006/2007 and now 2008. do you think they will take the current 2008 one?

bigunc, I'm a newbie also. I just got approved Friday. When I did the six month dr. supervised visits, all my dr. did was put on their that I did a 15 min treadmail workout three times a week. Hopes this helps.

I Got Approved!!!! 1/4/08

:Dafter six long weeks of waiting, I finally got approved. My husband on the other hand didn't because he only had three years of weight history. does anyone have any suggestions with regards to what we can do for his appeal?:help:

I still havent heard anything...this sucks!!!

Congrats Poopsie!!! I am so happy for you. Maybe mine will soon follow.

As of today, I am still waiting. I called this morning and was told it was being reviewed by doctors and they sent that over to the doctors on 12/21. They said it usually takes 7-10 days after that to hear something. This is driving me crazy!!

Tomecia, Thanks, I hope so. I'm glad your feeling great. What's a bodybugg? I spoke with the insurance company yesterday she said the file will go to the director today, so to check with them on Wednesday because of the holiday.

Congrats on your approval. Maybe I'm right behind you. I found out by surgeons office gave them a surgery date of 12/30/07, so maybe that will speed them up. Speical K, you may want to check on that. I was told they wouldn't cover either, but they did cover two visits. I had to pay a small fee, but it wasnt' over $40.

Thanks Tomecia!! I see you've just had your surgery, how do you feel? Special K, I would definately stay on them. I think it's ridiculous that you have to pay $50 to get you file. If they went to computer based, they should've been able to get all the info needed to compile a letter for you. I left my last PCP because of ignorant stuff like that and because her staff was so damn rude. I've always had pretty good insurance, so there wasn't a reason for them to be so rude. I know some doctors may treat you based on the type of insurance you have. Ughhh!!! Anyway, today, I finally got through to the department that makes the actually decisions and the lady called and told me personally that they received the five year history for me and three years for my husband. She said that there is one man that gives the final decision, so I should know soon because he has a deadline before the end of the year. I'm praying that they approve my husband with the info they have.

Well today they finally faxed it to the weight loss center. The nurse at the center has faxed it over to the insurance company today. Hopefully, we'll hear something soon.