sweetsagi

So I got the news that i was denied . I have a couple other co workers who had the same procedure done and was approved with out the 6 months supervised diet , 1 of them said she had her doc submit a letter stating that she was under his care and the other only did a 3 month supervised diet. I submited a letter and I did a 3 month supervised diet and I was denied with reason being I needed to be on a 6 month supervised diet which I guess I can go the other 3 months but does anyone know If I could appeal this decision and if so how do I go about it?:Banane20: It seems kind of unfair that they got through and I didnt using the exact same information but I guess it depends on your case worker and the mood they are in(lol)

Hi Kerri76 I was also denied and plan on appealing. I found this letter that one of the members posted. I plan on using it myself. Hope it helps. good luck! Dear (insurance Provider contact), I am appealing your decision for denying my medically needed weight-loss surgery. My ht and wt are __ and __ and my BMI is __. As statistics show and as medical doctors, you must be aware that diet and exercise help, but as a long term resolution to permanent wt-loss only 5% of people succeed. I am well aware of the risks with this surgery, but I believe the risks of being morbidly obesity out weigh the risks of surgery. I am _ years old and have been over-wt since I was _ years old. I have been on diets my whole life, having some success, but would always gain the wt back I lost, plus more. I will list the diets I have been on, but never kept any documentation because I could not have known at the time the insurance company would require it. Nor did I know that until this fairly new surgery even became an option for me, I would have to document wt loss before getting the surgery. (list ALL diets, wt- loss products, programs used. If possible, use documentation.) I have many co-morbid diseases, such as ___. (list meds also). You can also list family history related to obesity here.) (discuss everything about how morbid obesity affects your life) Sincerely, (your name) __________________

Im so sorry to hear that. What insurance do you have? Most insurance dont require that you have 2 co-morbidities if your BMI is over 40.

Hi there I know with my insurance I can call if I need a specialist that accepts the insurance and they provide me with a list. Maybe you can give them a call and they will be able to give you a list of biriatric surgeons in your area. you might have to go out of your area a little if you can t find any. good luck!:thumbup:

Hi there I have a sample refferral letter if you are still interested. You can send me a PM and I can email that to you. let me know and good luck!:scared2:

thats awesome...I cant wait to here the same also!!

Hi there I read some blogs where some people did theirs in Mexico and other places because it was so expensive out of pocket here in the US. Of course you will have to do some research but thats an alternative. Good luck!

Congratulation!!

Hi all IM new to this site and find it to be a great tool. I was wondering if anyone has been approved by BCBS of MN. I had my evals done my letter of medical necessity and I did weight management for almost a year and they will provide them with my information for the medical supervised diet. How long does the actual approval take? Does anyone know?:wink: